体重指数对不同卵巢反应性女性首次新鲜周期IVF助孕的影响  

Effect of body mass index on the outcome of IVF among patients with different ovarian responses

作　　者：张乾乾 何玉洁[1] ZHANG Qianqian;HE Yujie(Department of Obstetrics and Gynecology, the First Hospital of Shanxi Medical University, Shanxi 030001, China)

机构地区：[1]山西医科大学第一医院妇产科,太原030001

出　　处：《中国生育健康杂志》2021年第4期330-336,共7页Chinese Journal of Reproductive Health

摘　　要：目的探究体重指数(BMI)对不同卵巢反应性患者体外受精(IVF)助孕过程及结局的影响。方法收集2014—2018年于山西医科大学第一医院生殖遗传科首次IVF助孕并新鲜移植1712例患者临床资料。将所有入组病例分为卵巢低反应组、正常反应组、高反应组,再将每组患者分为4个亚组,即低体重组、正常体重组、超重组、肥胖组,比较各组助孕结局。将所有符合多囊卵巢综合征(PCOS)诊断患者再次按照BMI分为4个亚组。结果各卵巢反应组中,低体重组Gn起始剂量最少、Gn持续时间最短和总剂量最少;肥胖组Gn起始剂量最多、持续时间最长和总剂量最多。在卵巢正常反应组,正常体重组胚胎着床率最高,超重及肥胖组次之,低体重组最低(P<0.05)。在卵巢高反应组中,正常体重组获卵数最多,超重组及肥胖组获卵数减少,低体重组最少(P<0.05),但肥胖组周期取消率显著低于低体重组、正常体重组及超重组(P<0.05)。在PCOS组中,肥胖组可利用胚胎数、胚胎着床率低于正常体重组(P<0.05),肥胖组新生儿出生体重≥4000g明显高于其他三组(P<0.05)。各组间受精率、临床妊娠率、活产率、流产率、剖宫产率等差异均无统计学意义。结论BMI升高,女性不孕年限延长。在IVF助孕过程中,BMI既影响患者促排卵效果(即Gn起始剂量、使用时间及总剂量、获卵数),又影响可利用胚胎数、胚胎着床率、周期取消率及新生儿出生体重,而PCOS可能加剧了这些负面影响。BMI过低或过高均可能对助孕结局有影响。Objective To explore the effect of body mass index(BMI)on the process and outcome of in vitro fertilization(IVF)among patients with different ovarian responses.MethodsWe collected the clinical data of 1712 patients with IVF assisted pregnancy and fresh transplantation in the Department of Reproductive Genetics,the first hospital of Shanxi Medical University from 2014 to 2018.All the patients were divided into low response group,normal response group and high response group.Then,the patients in each group were divided into four subgroups:underweight(BMI<18.5 kg/m^(2)),normal weight(18.5-24 kg/m^(2)),overweight(24-28 kg/m^(2))and obese(BMI≥28 kg/m^(2)).We compared pregnancy outcomes in each group.All patients with PCOS were also compared among the four groups.ResultsIn each ovarian response group,the lowest initial dose,the shortest duration and the lowest total dose of Gn were found among underweight participants;the highest initial dose,the longest duration and the highest total dose of Gn were found among obese participants.In the normal ovarian response group,the implantation rate was the highest in the normal weight group,followed by the overweight and obese group,and the lowest was in the underweight group(P<0.05).In the high ovarian response group,the number of oocytes obtained in normal weight group was the most,followed by the overweight and obese group,while that in underweight group was the least(P<0.05),but the cycle cancellation rate in obese group was significantly lower than that in underweight,normal weight and overweight group(P<0.05).In PCOS group,the number of available embryos and the rate of embryo implantation in obese group were lower than those in normal weight group(P<0.05),and the percentage of newborns with birth weight≥4000 g in obese group was higher(P<0.05).There was no statistically significant difference in fertilization rate,clinical pregnancy rate,live birth rate,abortion rate and cesarean section rate among the groups(P>0.05).ConclusionThe duration of female infertility prolon

关 键 词：体重指数 肥胖症 不育 女(雌)性 生殖技术 辅助 卵巢反应性 

分 类 号：R71[医药卫生—妇产科学]