1. Bea Jaye Warlick, RN, BSN
N5033 Research in Nursing
Dr. Marianne MatzoSpring 2011
Obesity and Infertility: A Research Proposal

2. Introduction
As the most common chronic disease in the United States of America, overweight or obesity affects more than one third of all adults (Flegal, Carroll, Ogden, & Curtin, 2010).
According to Dorlands Medical Dictionary (1985) obesity is defined as an increase in body weight beyond the limitation of skeletal and physical requirement, as the result of an excessive accumulation of fat in the body.

3. Introduction
Obesity is associated with greater risks for adverse health outcomes across the reproductive spectrum, including higher rates of infertility (Luke et al., 2011, p. 245).
Infertility affects an estimated 12% of women of reproductive age (Luke et al., 2011, p. 246).
The prevalence of obesity in women of reproductive age, and in the infertile population, continues to increase with recent recognition that abdominal obesity is associated with greater metabolic disturbances and reduced conception even in ovulating women (Malik, 2009).

4. Problem Statement
Does obesity in reproductive age women, 35 years of age, effect pregnancy and live birth rates in in-vitro fertilization (IVF)?

5. Purpose
The purpose of this nursing study is to evaluate the effect of obesity, using Body Mass Index (BMI) categories, on pregnancy rates among women undergoing IVF.

6. Hypothesis
Obesity in reproductive aged women, less than or equal to 35 years of age, decreases pregnancy rates in in-vitro fertilization (IVF).

7. Theoretical Framework
Definitions
maintain optimal health and wellness
Orems model is separated into three conceptual theories which include: self care, self care deficit and nursing system (Orem, 1985).
Orems metaparadigm
Obesity is the result of a combination of reduced exercise, changes in dietary composition, and increased caloric intake (Bellver et al., 2010) and defined by BMI 30 kg/m.
Obesity is operationalized by BMI.
Orems Self Care Practice Model

8. Research Design
retrospective cohort study
nonprobability, convenience (accidental) sampling method
The study population will include 200 women of primary fertility age, 35 years of age, who will be undergoing their first cycle of in-vitro fertilization at Henry G. Bennett Fertility Institute between January 2009 and December 2011.

9. Inclusions
Exclusions
Patients with regular menstrual cycles (21-35 days)
Patients that have had NO hormonal therapy for the last three months
Patients that have had no systemic illnesses.
Male patients
Patients younger than 18
Patients with polycystic ovary syndrome (PCOS)
Patients with severe endometriosis
Cancelled IVF cycles
Research Design

10. Data Collection
Society for Assisted Reproductive Technology Clinic Online Reporting System (SART CORS)
This database contains data collected and verified by the SART, and reported to the Centers for Disease Control in compliance with the Fertility Clinic Success Rate and Certification Act of 1992 (Wyden Act).

11. Instrumentation
Body Mass Index (BMI)
weight in kilograms divided by the square of the height in meters (kg/m2)
predominant instrument that both medical clinicians and researchers use for classifying individuals into obesity categories

12. BMI Groups
underweight (BMI < 18.5 kg/m2)
normal weight (BMI 18.5-24.9 kg/m2)
overweight (BMI 25-29.9 kg/m2)
obese (BMI 30 kg/m2)
normal weight women are the reference group.

13. BMI Chart

14. Statistical Methods
One-tailed t-test
95% Power
Moderate effect size 0.40
Significance level of 0.01
ANOVA
Statistical significance p