代谢综合征对IVF/ICSI-ET助孕结局影响的临床观察  

Clinical observation on the impact of metabolic syndrome on the outcomes of IVF/ICSI-ET treatment

作　　者：姚霞[1] 李蓉[1] 黄士荷[1] 

机构地区：[1]北京大学深圳医院生殖医学中心,广东深圳518036

出　　处：《中国性科学》2013年第10期40-44,共5页Chinese Journal of Human Sexuality

摘　　要：目的:探讨代谢综合征与IVF-ET/ICSI过程及结局的关系。方法:回顾性分析从2009年1月至2013年3月于我院行长方案IVF或ICSI-ET辅助助孕患者共145个周期,所有患者在进入助孕周期前均未对代谢综合征进行预处理,按照WHO制定的亚洲成人BMI标准[1]的不同分为三组:A组(正常组,18.5 kg/m2≤BMI<23 kg/m2)、B组(超重组,23 kg/m2≤BMI<25 kg/m2)、C组(肥胖组,BMI≥25 kg/m2);又根据2005年国际糖尿病联盟(IDF,2005年)[3]制定的代谢综合征标准降B、C各分为两组:B1组(超重非代谢综合征组),B2组(超重代谢综合征组),C1组(肥胖非代谢综合征组),C2组(肥胖代谢综合征组);比较各组患者一般情况、治疗情况及妊娠结局。结果:(1)基础情况:BMI值及腹围A、B、C三组差异显著(P<0.01)。(2)治疗情况:Gn用量C2组均稍高于其他各组(P<0.05);HCG日E2值及MⅡ期卵细胞数:B2、C2组均显著低于A组(P<0.01);获卵数,胚胎数B2、C1、C2组均低于A组(P<0.05);优质胚胎数C2组显著少于A组(P<0.01)。(3)妊娠结局:胚胎种植率、临床妊娠率A、B1、C1组均显著高于B2及C2组(P<0.01);不良妊娠率B2、C2组显著高于A组(P<0.01),B2、C2组的不良妊娠率高于B1、C1组,但无统计学意义(P>0.05)。结论:代谢综合征可能通过降低卵巢反应及内膜容受性来对患者产生不良影响。接受ART治疗的代谢综合征超重及肥胖患者妊娠结局明显差于正常体重患者,但超重及肥胖未伴代谢综合征的患者和正常体重患者的妊娠结局并不明显。Objectives： To study the relationship between metabolic syndrome and the outcome of IVF- ET/ICSI. Method： 145 ICSI- ET assisted pregnant women were included in a retrospective analysis, and all participants did not get any pre - treatment for metabolic syndrome. According to BMI standard made by WHO for Asian people and the standard of the classi- fication of metabolic syndrome made by IDF, participants were divided into 3 large groups （ A, B, C） and within group B and group C, 2 small groups B1, B2 and C1, C2. The general conditions and treatment outcomes of each group were compared and analyzed. Results： （ 1 ） the general condition ： as for the BMI level and the abdomen circumference among these three groups, there is a significant difference. （ P 〈 0. 01 ） （2） treatment outcomes ： Gn administered in C2 is significantly more than other groups and index like HCG E2 per day, MII eggs, eligible eggs and embryos are significantly lower than other groups. （3） Preg- nant outcomes： conception rate, pregnant rate of A, B1, C1 is significantly higher than B2 and C2. Incident rates of adverse pregnancy of B2 and C2 are higher than A with a significant difference and are higher than B1 and C1 withom a significant differ- ence. Conclusion： metabolic syndrome affects human health by lowering ovary function and endometrium tolerance. Pregnant outcomes of overweight and obesity patients were not significantly different while they were inferior to normal people.

关 键 词：代谢综合征 体重指数 超重 肥胖 体外受精 

分 类 号：R589.2[医药卫生—内分泌]