体重指数对不孕女性夫精宫腔内人工授精周期妊娠结局的影响  

The effect of body mass index on pregnancy outcome of the intrauterine artificial insemination by husband cycle in infertile patients

作　　者：杨泽欣 白雪莲 韩莹 邹璋翔 张印峰[2] 张云山[2] YANG Ze-xin;BAI Xue-lian;HAN Ying;ZOU Zhang-xiang;ZHANG Yin-feng;ZHANG Yun-shan(Graduate School,Tianjin Medical University,Tianjin 300070,China;Department of Reproductive Center Tianjin Central Obstetrics and Gynecology Hospital,Tianjin Key Laboratory of Human Development and Reproductive Regulation,Tianjin 300100,China)

机构地区：[1]天津医科大学研究生院,天津300070 [2]天津市中心妇产科医院生殖中心,天津市人类发育与生殖调控重点实验室,天津300100

出　　处：《天津医科大学学报》2022年第3期305-309,共5页Journal of Tianjin Medical University

摘　　要：目的:探索体重指数(BMI)对不孕女性夫精宫腔内人工授精(IUI)周期妊娠结局的影响。方法:回顾性分析2015年1月—2020年6月于天津市中心妇产科医院生殖中心施行IUI治疗的3707例患者的周期资料,按照BMI分为3组,A组(正常体质量组18.5 kg/m^(2)≤BMI<23.0 kg/m^(2))、B组(超重组23.0 kg/m^(2)≤BMI<25.0 kg/m^(2))、C组(肥胖组BMI≥25.0 kg/m^(2)),比较各组间一般资料以及妊娠结局。结果:在方案中,3组间自然周期方案占比差异均有统计学意义(P<0.01),口服药物联合肌注促排药物方案差异均有统计学意义(P<0.01);BMI与活产率无关,B组(OR=1.161,95%CI:0.861~1.565,P=0.328)以及C组(OR=1.003,95%CI=0.761~1.322,P=0.948)与A组活产率差异无统计学意义;肌注促排药物(OR=1.425,95%CI:1.026~1.980,P=0.035)以及口服药物联合肌注促排药物(OR=1.366,95%CI:1.038~1.796,P=0.026)是影响活产率的独立因素。肥胖(OR=2.784,95%CI:1.471~5.267,P=0.002)以及继发性不孕(OR=3.048,95%CI=1.454~6.389,P=0.003)是早期流产的危险因素。结论:肥胖以及继发性不孕为早期流产的危险因素,促排药物可提高不孕患者IUI活产率。Objective:To explore the influence of body mass index(BMI)on the pregnancy outcome of intrauterine insemination(IUI)cycle in infertile patients.Methods:The cycle data of 3707 patients who underwent IUI treatment at the Reproductive Center of Tianjin Central Obstetrics and Gyn ecology Hospital from January 2015 to June 2020 were retrospectively analyzed.They were divided into 3 groups according to BMI,group A(normal body weight group:18.5 kg/m^(2)≤BMI<23.0 kg/m^(2)),group B(overweight:23.0 kg/m^(2)≤BMI<25.0 kg/m^(2)),group C(obese group:BMI≥25.0 kg/m^(2)).The general data of patients and pregnancy outcome were comparedamong the groups.Results:In the protocol,the difference in the proportion of the natural cycle protocol among the three groups was group A>group B>group C(P<0.01),and the differences were statistically significant.The difference in the proportion of the oral ovulation induction combined with injectable ovulation induction protocol among the three groups was group C>group B>group A(P<0.01),and the differences were statistically significant.BMI is no associated with live birth rate,the differences of group B(OR=1.161,95%CI:0.861-1.565,P=0.328)and group C(OR=1.003,95%CI:0.761-1.322,P=0.948)and group A live birth rates were statistically significant.Injectable ovulation induction protocol(OR=1.425,95%CI:1.026-1.980,P=0.035)and oral ovulation induction combined with injectable ovulation induction protocol(OR=1.366,95%CI:1.038-1.796,P=0.026)affect live birth rate as an independent factor.Obesity(OR=2.784,95%CI:1.471-5.267,P=0.002)and primary infertility(OR=3.048,95%CI:1.454-6.389,P=0.003)were risk factors for early miscarriage.Conclusion:Obesity and primary infertility are risk factors for early miscarriage.Ovulation induction programs for patients have positive significance for improving the IUI pregnancy outcome of infertile patients.

关 键 词：宫腔内人工授精 体重指数 活产率 早期流产率 

分 类 号：R711.6[医药卫生—妇产科学]