体重指数对体外受精-胚胎移植治疗结局的影响分析  

Analysis of the influence of body mass index on outcome of in vitro fertilization and embryo transfer

作　　者：刘海鹏[1] 贺平[1] 陈艺[1] 杜丹[1] 彭姝明[1] 

机构地区：[1]湖南省郴州市第一人民医院生殖医学中心,湖南郴州423000

出　　处：《生殖医学杂志》2013年第5期324-328,共5页Journal of Reproductive Medicine

摘　　要：目的探讨体重指数(body mass index,BMI)对于体外受精-胚胎移植(IVF ET)治疗结局的影响。方法回顾性分析2010年1月至2012年6月在本中心共1,213例应用长方案IVF/卵胞浆内单精子注射(ICSI)治疗的患者。按年龄将患者分为<35岁组,≥35岁组。再按照世界卫生组织(WHO)推荐的亚洲人的BMI分类标准分为:低BMI组(<18.5kg/m^2):正常BMI组(18.5kg/m^2≤BMI<23kg/m^2);超重及肥胖组(≥23kg/m^2)。分别比较患者的基本临床资料和妊娠结局以评估BMI对IVF-ET治疗结局的影响。结果 BMI超重及肥胖组患者的促性腺激素((Gn)用量及促排卵天数与正常BMI组和低BMI组相比较均明显增加(P<0.05)。当患者年龄<35岁时超重及肥胖组患者的优质胚胎率、临床妊娠率均低于正常BMI组和低BMI组,早期流产率则高于其它二组(P<0.05)。而当患者年龄≥35岁时各指标三组间无统计学差异(P>0.05)。结论 IVF-ET治疗患者Gn用量及促排卵天数随BMI的增长而增加。患者年龄≥35岁时BMI对于IVF/ICSI-ET妊娠结局无显著影响;患者年龄<35岁时BMI超标对于IVF/ICSI-ET妊娠结局有负面的影响,适当的控制体重将可能有利于改善IVF-ET的治疗结局。Objective; To explore the influence of body mass index（BMI）on outcome of in vitro fertilization and embryo transfer（IVF）. Methods： A retrospective study was conducted in our reproductive center from January 2010 to July 2012. A total of 1,213 patients with the first long protocol IVF/ICSI-ET cycle were included in the study and divided into two groups according to the patient＇s age〈35 or ≥35. And the patients were also divided into three groups according to the World Health Organization BMI criteria of Asian. Underweight group （ 〈18.5 kg/m2 ） , normal weight group （ 18. 5 kg/m2 ≤ BMI 〈23 kg/m^2） , overweight group （≤23 kg/m2）. The basic clinical data, oocyte and embryo status, and pregnancy outcome were analyzed and compared among different BMI groups. The correlation between BMI and IVF/ICSI-ET outcome also analyzed. Results： The mean dose and the total stimulated days of gonadotrophin in overweight group was the highest among the three groups（P〈0.05）. When patients aged less than 35 years, good quality embryo rate and clinical pregnancy rate in the overweight group were lower than normal BMI group and low BMI group, while early pregnancy loss rate was significantly higher than the other two groups（P〈0. 05）.There was no significant difference for each parameter among the three groups when the patient aged 35 years or older（P〉0.05）. Conclusions： An elevated BMI significantly is correlated with the increased dose and the total days of gonadotrophin administration. An increase in BMI does not appear to have an adverse effect on IVF/ICSI- ET outcome when the patients aged ≥35 years. When patients aged 〈35 years,overweight impairs IVF/ ICSI-ET outcome. Appropriate weight control may help to improve the treatment outcome of IVF/ ICSI-ET.

关 键 词：体重指数 体外受精-胚胎移植 

分 类 号：R71[医药卫生—妇产科学]