女性体重指数对IVF/ICSI周期结局的影响  

Effects of female body mass index on the outcomes of IVF/ICSI cycles

作　　者：马龙[1] 韩乐 马翔[1] 刁飞扬[1] 蔡令波[1] 刘嘉茵[1] MA Long;HAN Le;MA Xiang;DIAO Feiyang;CAI Lingbo;LIU Jiayin(Center of Clinical Reproductive Medicine,the First Affiliated Hospital of Nanjing University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院生殖医学中心,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2022年第1期71-74,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：国家重点研发计划(2017YFC1001004,2017YFC1001303);国家自然科学基金(81471429,81571403)。

摘　　要：目的:探讨体外受精/卵胞浆内单精子注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)助孕的女性体重指数(body mass index,BMI)对鲜胚移植周期临床结局的影响。方法:回顾性分析2016年6月—2018年6月在本中心首次IVF/ICSI治疗并行单个鲜胚移植的1784例患者临床资料,按照BMI值(中国标准)分为偏瘦组(150例,BMI<18.5 kg/m^(2))、正常组(1098例,18.5 kg/m^(2)≤BMI<24.0 kg/m^(2))、超重组(437例,24.0 kg/m^(2)≤BMI<28.0 kg/m^(2))、肥胖组(99例,BMI≥28.0 kg/m^(2)),并以不同受精方式分为IVF亚组和ICSI亚组。比较新鲜周期的获卵数、临床妊娠率、种植率、活产率、流产率的区别,以及各亚组间受精率和优质胚胎率的差异。结果:偏瘦组获卵数显著高于其余3组,肥胖组获卵数均显著低于其余3组(P<0.01);超重组的临床妊娠率显著低于正常组,超重组和肥胖组的种植率显著低于正常组(P<0.05);4组的活产率、流产率均没有统计学差异(P>0.05);4组中IVF亚组和ICSI亚组的受精率、优质胚胎率差异均没有统计学意义(P>0.05)。结论:女性肥胖对IVF/ICSI周期的治疗结局有负面影响。与BMI正常的女性相比,超重和肥胖女性鲜胚移植周期的种植率显著下降。Objective:To investigate the effect of female body mass index(BMI)on the outcomes of IVF/ICSI cycles after fresh embryo transfer.Methods:The data of 1784 cycles,which were accomplished with single fresh embryo transfer in the first IVF/ICSI treatment,are analyzed retrospectively,the cycles were divided into four groups according to the recommended Chinese BMI cut-off:underweight(150 cycles,BMI<18.5 kg/m^(2)),normal weight(1098 cycles,18.5 kg/m^(2)≤BMI<24.0 kg/m^(2)),overweight(437 cycles,24.0 kg/m^(2)≤BMI<28.0 kg/m^(2)),obese(99 cycles,BMI≥28.0 kg/m^(2)),and the cycles were also subdivided into IVF and ICSI group by different insemination methods.We compared the number of oocytes,clinical pregnancy rates,implantation rates,live birth rates,miscarriage rates among the four groups,and also compared the fertilization rates and the high quality embryo rates among the subgroups.Results:The number of oocytes retrieved in the underweight group was significantly higher than those of the other three groups,and the number of oocytes retrieved in the obese group was significantly lower than those of the other three groups(P<0.01).The clinical pregnancy rate of overweight group was significantly lower than that of normal weight group,and the implantation rate of overweight group and obese group was significantly lower than that of normal weight group;the live birth and miscarriage rates in the four groups were no significant difference(P>0.05).There were no significant difference in fertilization rates and high quality embryo rates between the IVF subgroup and the ICSI subgroup(P>0.05).Conclusion:Female obesity has a significant negative effect on the outcomes of IVF/ICSI cycles.Compared with women with normal BMI,overweight and obese women decrease implantation rates after the fresh embryo transfer.

关 键 词：体外受精 体重指数 妊娠率 种植率 活产率 

分 类 号：R321[医药卫生—人体解剖和组织胚胎学]