体重指数和年龄对非多囊卵巢综合征不孕患者体外受精的影响  

Effects of body mass index and age on the treatment of in vitro fertilization-embryo transfer among patients with non-polycystic ovarian syndrome

作　　者：陈虹[1] 王文军[1] 陈玉珍[1] 麦美琪[1] 欧阳能勇[1] 陈静华[1] 庹平[1] 

机构地区：[1]中山大学第二附属医院妇产科生殖医学中心,广州510120

出　　处：《中华流行病学杂志》2010年第5期567-571,共5页Chinese Journal of Epidemiology

摘　　要：目的探讨体重指数（BMI）和年龄对非多囊卵巢综合征（PCOS）不孕症患者体外受精-胚胎移植（IVF—ET）及卵细胞浆单精子注射（ICSI）结局的影响。方法回顾性分析IVF-ET治疗的非PCOS不孕症患者1426例。比较BMI（低体重：BMI〈18．5kg／m^2，标准体重：BMI18．5～23．99kg／m^2，超重肥胖：BMI≥24kg／m^2）与年龄（低龄：20～34岁，高龄：35～45岁）对卵巢控制性超排卵[包括促性腺激素（On）用量及使用天数、人绒毛膜促性腺激素（HCG）注射日血清E2水平、获卵数及成熟卵数]、受精数、双原核（2PN）数、卵裂数、正常胚胎数、冷冻胚胎数及治疗结局的影响。结果（1）高龄者的Gn总量与年龄呈正相关（P〈0．001），Gn总量总变异的12．70％与高龄有关（标准化偏回归系数为0．343）；（2）超重肥胖及高龄者HCG日E2值分别与BMI及年龄呈负相关（P值分别为O．037和0．018），HCG日E2值总变异的0．80％与高龄及超重肥胖有关，而高龄因素影响稍大（标准化偏回归系数分别为0．066和0．058）；（3）高龄者的Gn使用天数、获卵数、成熟卵数、受精数、卵裂数、2PN数、正常胚胎数及冷冻胚胎数均与年龄呈负相关（P〈0．05）；（4）高龄低体重及高龄正常体重者妊娠的优势分别是低龄正常体重者的0．482倍和0．529倍。结论年龄是影响非PCOS不孕患者IVF／ICSI治疗及结局的因素之一；未发现BMI对非PCOS不孕患者IVF／ICSI结局有影响，但超重或肥胖者在接受治疗前适当减轻体重可减少控制性超排卵过程中的Gn用量。Objective To investigate the impacts of body mass index （BMI） and age on in vitro fertilization-embryo transfer （IVF） and intracytoplasmic sperm injection （ICSI） treatment in infertile patients without polycystic ovary syndrome （PCOS）. Methods A retrospective study of 1426 patients during Jun. 2001 - Nov. 2009 was carried out. Multiple regression was used to analyze the effects of BMI （low weight： BMI〈 18.5 kg/m2, normal weight： BMI 18.5-23.99 kg/m2 and over weight-obesity： BMI≥24 kg/m2） and age （young： 20-34 years old, eld： 35-45 years old） on controlled ovarian stimulation （COH） [ including： dose and duration of Gn, E2 level on day of human chorionic gonadotropin （HCG） administration, number of oocytes collected and full-grown follicles ], number of fertilization, cleavage, two-pronucleus, normal embryos and cryopreserved embryos and clinical pregnancy outcome. Results （ 1 ） Gn dose for the patients whose age were 35 and the above, had a positive correlation with age （P〈0.001）, 12.70% of the total variation of Gn dose was related to age （standardized partial regression coefficient was 0.343）. （2） Estradiol level on day of HCG administration had a negative correlation with BMI in overweight-obesity patients, and so were the patients whose age were 35 and above （P value respectively lower than 0.037 and 0.018）. 0.80% of the total variation of estradiol （HCG day） is related to age and overweight-obesity while age took greater proportion （standardized partial regression coefficients were 0.066 and 0.058 respectively）. （3） For older patients, age appeared to have negative relationships with duration of Gn and number of oocytes collected, full-grown follicles, fertilization, cleavage, two-pronucleus, normal embryos and cryopreserved embryos （P〈0.05）. （4）Comlgared to young-normal weight patients, the odds ratio of pregnancy in eld-low weight and eld-overweight-obesity patients were 0.482 and 0.529 （P〈0.05） respectively. C

关 键 词：体重指数 年龄 多囊卵巢综合征 不孕症 体外受精-胚胎移植 

分 类 号：R714.8[医药卫生—妇产科学]