肥胖对不孕女性ART助孕结局的影响  

The Influence of Obesity on the Outcome of ART in Infertile Women

作　　者：牛艳玲 马利亚[2] 袁莹莹[3] 赵君利[3] NIU Yanling;MA Liya;YUAN Yingying;ZHAO Junli(Department of Gynecology,Wuzhong People's Hospital,Wuzhong 751100,China;Information Center,the General Hospital of Ningxia Medical University,Yinchuan 750004,China;Reproductive Medicine Center,the General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]吴忠市人民医院妇科,吴忠751100 [2]宁夏医科大学总医院信息中心,银川750004 [3]宁夏医科大学总医院生殖医学中心,银川750004

出　　处：《宁夏医科大学学报》2022年第10期1019-1023,共5页Journal of Ningxia Medical University

基　　金：宁夏科技惠民项目(2015KJHM08)。

摘　　要：目的探讨肥胖对不孕女性辅助生殖技术(assisted reproductive technology,ART)助孕结局的影响。方法回顾性分析2016—2018年接受体外受精/卵胞质内单精子显微注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)助孕的495例女性患者临床资料,所有患者采用黄体期长方案促排,年龄21~38岁。以体质量指数(BMI)将不孕患者分为体质量正常组(n=238)和肥胖组(n=257),比较两组患者一般情况(年龄、不孕年限、不孕因素、受精方式、基础激素)、促排卵结局[促性腺激素(Gn)用量及使用天数、获卵数、成熟卵母细胞(MⅡ)数、受精数(2PN)、优质胚胎数]及妊娠结局[种植率、生化妊娠率、临床妊娠率、流产率、早产率、抱婴率、分娩孕周及新生儿出生体质量、妊娠期高血压(pregnancy induced hypertension,PIH)和妊娠期糖尿病(gestational diabetes mellitus,GDM)发生率]。再将所有非正常BMI患者分为超重组(n=111)、Ⅰ度肥胖组(n=121)、Ⅱ度肥胖组(n=25),比较三组患者上述各项指标情况。结果肥胖组bFSH/bLH值和PCOS发生率均高于体质量正常组(P均<0.05)。肥胖组种植率、临床妊娠率、抱婴率、分娩孕周及新生儿出生体质量与正常组相比明显降低,Gn用量及天数、生化妊娠率、早产率、PIH及GDM发生率均升高(P均<0.05)。不同肥胖程度组间,分娩孕周及新生儿出生体质量随BMI增加呈下降趋势(P均<0.05),组间Gn用量和天数、种植率、生化妊娠率、早产率、临床妊娠率、抱婴率、PIH和GDM发生率比较差异无统计学意义(P均>0.05)。结论肥胖使临床妊娠率降低,早产率、妊娠并发症发生率升高,并随着肥胖程度增加,分娩孕周及新生儿出生体质量呈明显下降趋势。Objective To explore the effect of obesity on the outcome of ART in infertile women.Methods A retrospective analysis of the clinical data of 495 female patients who underwent IVF/ICSI from 2016 to 2018.All patients were used the long-term luteal phase to promote their discharge,aged 21-38 years old.Infertile patients were divided into normal group(n=238)and obese group(n=257)by BMI,and the general conditions of the two groups(age,length of infertility,infertility factors,fertilization methods,basic of hormone),the outcome of ovulation induction(the amount of Gn and the number of days of use,the number of eggs obtained,the number of MⅡeggs,the number of 2PN fertilization,the number of high-quality embryos)and the pregnancy outcome(implantation rate,biochemical pregnancy rate,clinical pregnancy rate,abortion rate,pretermdelivery rate,infant holding rate,Gestational week of delivery and birth weight of newborn,incidence of PIH and GDM).Then all patients with abnormal BMI were divided into overweight group(n=111),degreeⅠobesity group(n=121),degreeⅡobesity group(n=25),the above indicators of the three groups of patients were compared.Results The value of bFSH/bLH and the incidence of PCOS in obese group were higher than those in normal weight group(P all<0.05).Compared with the normal group,the implantation rate,clinical pregnancy rate,baby holding rate,delivery gestational weeks and neonatal birth weight in the obese group were significantly lower,and the amount and use time of Gn,biochemical pregnancy rate,preterm birth rate,PIH and GDM incidence were higher(P all<0.05).Among different obesity groups,the gestational week of delivery and the birth weight of newborns showed a downward trend with the increase of BMI(P all<0.05).There was no significant difference in Gn volume,Gn days,implantation rate,biochemical pregnancy rate,preterm delivery rate,clinical pregnancy rate,baby holding rate,PIH and GDM between the groups(P all>0.05).Conclusion Obesity reduces the clinical pregnancy rate,increases the premature bi

关 键 词：肥胖 不孕女性 辅助生殖技术 助孕结局 

分 类 号：R714.8[医药卫生—妇产科学]