月经规律女性体质量指数对体外受精-胚胎移植治疗卵巢反应性及妊娠结局的影响  

Influence of body mass index on ovarian response and pregnancy outcome in ovulatory women undergoing in vitro fertilization-embryo transfer

作　　者：应瑛 丘福满 刘见桥[1] 李斯晨[1] 黄青[1] 刘海英[1] Ying Ying;Qiu Fuman;Liu Jianqiao;Li Sichen;Huang Qing;Liu Haiying(Center for Reproductive Medicine,Department of Obstetrics and Gynecology,Key Laboratory for Major Obstetric Diseases of Guangdong Province,the Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China;The School of Public Health,Guangzhou Medical University,Guangzhou 511436,China)

机构地区：[1]广州医科大学附属第三医院,广东省产科重大疾病重点实验室,妇产科,生殖医学中心,510150 [2]广州医科大学公共卫生学院,511436

出　　处：《中华生殖与避孕杂志》2021年第8期739-746,共8页Chinese Journal of Reproduction and Contraception

基　　金：国家自然科学基金青年科学基金项目(81701518,81801532)。

摘　　要：目的:探究月经规律女性体质量指数(body mass index,BMI)与超促排卵卵巢反应性及体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)结局是否存在关联。方法:本研究为回顾性队列研究,收集2019年1月至2020年4月期间在广州医科大学附属第三医院行IVF助孕患者资料,根据世界卫生组织(World Health Organization,WHO)推荐的亚洲人BMI分级标准,将符合纳入标准的患者分为低BMI组(BMI<18.5 kg/m^(2),n=212)、正常BMI组(BMI 18.5~23.0 kg/m^(2),n=1076)、高BMI组(BMI 23.0~25.0 kg/m^(2),n=308)和肥胖组(BMI≥25.0 kg/m^(2),n=287)4个队列,主要结局指标为获卵数、卵巢反应性和持续妊娠率。结果:各组的获卵数和卵巢反应性差异均无统计学意义(P均>0.05)。高BMI组和肥胖组的M II卵率、受精卵子数、可用胚胎数、优质胚胎数和移植胚胎数与正常BMI组比较差异均无统计学意义(P均>0.05)。各组的移植优质胚胎比例、因卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)风险全胚冷冻率、种植率、临床妊娠率、早期流产率、持续妊娠率等差异均无统计学意义(P均>0.05)。此外,通过logistic回归分析校正混杂因素后仍未显示BMI与卵巢反应性及持续妊娠率之间存在关联。结论:月经规律的女性BMI增高不影响卵巢反应性及IVF妊娠结局。Objective To explore whether the body mass index(BMI)of women with regular menstruation is associated with ovarian response to ovarian hyperstimulation and the outcome of in vitro fertilization-embryo transfer(IVF-ET).Methods This retrospective cohort study uses data of IVF during the study period from the Center for Reproductive Medicine of the Third Affiliated Hospital of Guangzhou Medical University.According to the Asian BMI classification standard recommended by World Health Organization(WHO),the patients who met the inclusion criteria were divided into 4 groups:low BMI group(BMI<18.5 kg/m^(2),n=212),normal BMI group(BMI 18.5-23.0 kg/m^(2),n=1076),high BMI group(BMI 23.0-25.0 kg/m^(2),n=308)and obesity group(BMI≥25.0 kg/m^(2),n=287).The main outcome measures were the number of oocytes retrieved,ovarian response and ongoing pregnancy rate.Results There were no significant differences in the number of oocytes retrieved and ovarian response among the four groups(P>0.05).Outcomes of embryo culture(including MII oocyte rate,fertilized number,numbers of available embryos and high-quality embryos)and the number of transferred embryos were not statistically significant in high BMI group and obesity group when compared with normal BMI group(P>0.05).Furthermore,no significant differences were found in the rate of high-quality embryo transferred,the freeze-all rate due to ovarian hyperstimulation syndrome(OHSS)risk,rates of implantation,clinical pregnancy,early miscarriage and ongoing pregnancy among the four groups(P>0.05).In addition,after adjusting for confounding factors by logistic regression analysis,no association was found between BMI and ovarian response and ongoing pregnancy rate.Conclusion The increase of BMI in women with regular menstruation has no influence on ovarian response and IVF pregnancy outcome.

关 键 词：体质量指数 卵巢反应性 受精 体外 胚胎移植 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]