体质指数对多囊卵巢综合征患者经辅助生殖治疗后妊娠结局的影响  

Effect of body mass index on pregnancy outcomes of patients with polycystic ovary syndrome after assisted reproduction treatment

作　　者：朱亮[1] 王智超[2] 韩瑞刚[1] 王斌[1] 金丹[1] 杨静[1] 

机构地区：[1]解放军第306医院生殖医学中心,北京100101 [2]安徽医科大学,安徽合肥230032

出　　处：《中国妇幼保健》2017年第7期1531-1534,共4页Maternal and Child Health Care of China

基　　金：首都市民健康项目培育项目(Z151100003915093)

摘　　要：目的探讨体质指数(BMI)对多囊卵巢综合征(PCOS)患者经辅助生殖治疗后妊娠结局的影响。方法研究对象均为接受首个周期IVF-ET治疗的盆腔输卵管因素不孕患者。满足入选条件的超重/肥胖PCOS患者归入超重PCOS组;体重正常PCOS患者归入正常体重PCOS组;卵巢正常反应患者归入对照组。比较各组的基本情况以及辅助生殖治疗的各项临床及实验室参数。结果与对照组相比,超重和正常PCOS组促性腺激素用药量增加、用药时间延长,hC G日雌二醇(E_2)和孕酮(P)水平增高,hC G日≥14 mm的卵泡数、获卵数、MII卵子数、2PN数均显著增高,但2PN率、优良胚胎率显著下降,临床妊娠率和胚胎种植率显著下降,而卵巢过渡刺激综合征(OHSS)发生率和自然流产率显著增高(P<0.05)。与非超重PCOS组相比,超重PCOS组促性腺激素用药时间显著延长,2PN率进一步降低(P<0.05)。结论超重PCOS患者IVF助孕治疗临床妊娠率降低、自然流产率增高,很可能是因为卵子质量下降导致正常受精率降低所致。Objective To explore the effect of body mass index（ BMI） on pregnancy outcomes of patients with polycystic ovary syndrome（ PCOS） after assisted reproduction treatment. Methods The infertile patients caused by pelvic and tubal factors underwent in vitro fertilization and embryo transfer（ IVF-ET） in the hospital. The patients with overweight and obesity were designed as overweight PCOS group; the patients with normal weight were designed as normal weight PCOS group; the patients with normal ovarian response were designed as control group. The basic situations,clinical and laboratory indexes of IVF-ET in the three groups were compared. Results Compared with control group,the doses of gonadotrophin in the other groups increased,the medication time prolonged,the levels of estradiol and progesterone on the day of human chorionic gonadotropin（ hC G） injection increased,the numbers of follicles≥14 mm on the day of hC G injection,the nubmers of oocytes retrieved,the nubmers of MⅡ oocytes,and the nubmers of 2PN increased significantly,but the rates of 2PN,the rates of high-quality embryos,clinical pregnancy rates,and embryo implantation rates decreased significantly,the incidence rates of ovarian hyperstimulation syndrome（ OHSS） and spontaneous abortion increased significantly,there were statistically significant differences（ P〈0. 05）. Compared with non-overweight PCOS groups,the medication time in overweight PCOS group prolonged significantly,the rate of 2PN decreased significantly（ P〈0. 05）. Conclusion The clinical pregnancy rate of overweight PCOS patients after IVF-ET decreases,the rate of spontaneous abortion increases,which may be caused by decrease of normal fertilization rate due to reduced oocyte quality.

关 键 词：多囊卵巢综合征 体质指数 人类辅助生殖 

分 类 号：R714.256[医药卫生—妇产科学]