体重指数异常对体外受精-胚胎移植妊娠结局的影响  

Abnormal body mass index may adversely affect IVF-ET outcome

作　　者：肖宇[1] 黄永刚[1] 侯晓红[1] 吕杰强[1] 

机构地区：[1]温州医学院附属第二医院生殖医学中心,325027

出　　处：《浙江医学》2013年第9期754-757,共4页Zhejiang Medical Journal

摘　　要：目的探讨体重指数(BMI)异常对体外受精-胚胎移植(IVF-ET)妊娠结局的影响。方法回顾接受垂体降调节长方案IVF-ET治疗的738例不孕患者共807个周期,根据BMI标准分为3组:低体重组(BMI<18.5 kg/m2)184个周期,正常组(18.5kg/m2≤BMI<24 kg/m2)457个周期,超重组(BMI≥24 kg/m2)166个周期,所有患者均接受促性腺激素释放激素激动剂(GnRH-a)联合重组卵泡刺激素(rFSH)及人绝经期促性腺激素(HMG)的垂体降调节长方案促排卵治疗。比较3组患者的卵巢反应性、胚胎情况及妊娠结局。结果超重组Gn用量及使用天数均高于正常组,但差异无统计学意义(P>0.05)。3组间获卵数、受精率、卵裂率相似。超重组生化妊娠率、临床妊娠率、胚胎种植率、活产率均明显低于正常组,差异均有统计学意义(均P<0.05),低体重组虽低于正常组,但差异无统计学意义(P>0.05)。超重组流产率高于正常组,但各组间差异无统计学意义(P>0.05)。结论低体重或超重可对IVF-ET治疗的生化妊娠率、临床妊娠率、胚胎种植率、活产率、流产率等妊娠结局造成负面影响。Objective To assess the effects of abnormal body mass index （BMI） on reproductive outcomes in in vitro fer- tilization-embryo transfer （IVF-ET）. Methods The clinical data of 807 IVF/intracytoplasmic sperm injection （ICSI） cycles from 738 infertile couples were retrospectively analyzed. According to body mass index of females, total 807 cycles were divided into 3 groups： underweight group （BMI 〈 18.5kg/m2, n= 184）, normal group （18.5kg/m2 ≤ BMI 〈24kg/m2, n=457） and overweight group （BMI≥24kg/m2, n=166）. Response of ovarian, embryo quality, and reproductive outcomes were compared among groups. Results There were no differences in total number of oocytes and embryos, the rates of fertilization and cleavage among 3 groups. The biochemical pregnancy, clinical pregnancy, implantation and live birth rates were significantly poorer in overweight group than those in normal group（P〈0.05）. This trend existed in underweight group, however, all the differences were not significant （P 〉0.05）. Compared to normal group, the miscarriage rate in overweight was higher, but no difference was found among three groups（P 〉0.05）. Conclusion pregnancy,clinical pregnancy, implantation and live birth rates, and elevated miscarriage rate in IVF-ET.

关 键 词：体重指数 体外受精-胚胎移植 超重 肥胖 低体重 

分 类 号：R714.8[医药卫生—妇产科学]