体质量指数在冻融胚胎移植周期中对多囊卵巢综合征合并不孕症患者妊娠结局的影响  

Effect of body mass index in frozen-thawed embryo transfer cycles on pregnancy outcomes of infertile patients with polycystic ovary syndrome

作　　者：程玲 颜晓红[1] 李友筑[1] CHENG Ling;YAN Xiao-hong;LI You-zhu(Department of Reproductive Medicine,the First Affiliated Hospital of Xiamen University,Xiamen,Fujian 361003,China)

机构地区：[1]厦门大学附属第一医院生殖医学科,福建厦门361003

出　　处：《中国妇幼保健》2024年第4期663-666,共4页Maternal and Child Health Care of China

基　　金：福建省自然科学基金资助项目(2019J01565)。

摘　　要：目的探讨体质量指数(BMI)在冻融胚胎移植(FET)周期中对多囊卵巢综合征(PCOS)合并不孕症患者妊娠结局的影响。方法选取2017年1月—2020年12月就诊于厦门大学附属第一医院生殖医学科进行FET的PCOS合并不孕症患者213例,按照BMI分为3组:偏瘦组(BMI<18.5 kg/m^(2),17例)、正常组(18.5 kg/m^(2)≤BMI<24.9 kg/m^(2),137例)、超重组(BMI≥25 kg/m^(2),59例)。比较3组的一般临床资料和妊娠结局。结果3组患者促性腺激素(Gn)天数、Gn总量、人绒毛膜促性腺激素(hCG)日雌二醇(E_(2))水平、BMI、基础黄体生成素(LH)比较差异均有统计学意义(均P<0.05)。3组获卵数、MⅡ卵数、活产率、早产率比较差异均有统计学意义(均P<0.05)。正常组的获卵数[(16.52±6.21)个]、MⅡ卵数[(14.39±5.59)个]、活产率(42.34%)高于超重组[(13.97±5.88)个,(12.42±5.20)个,20.34%],早产率(12.41%)低于超重组(37.50%),差异均有统计学意义(均P<0.05)。偏瘦组活产率(58.82%)高于超重组,早产率(0.00%)低于超重组,差异均有统计学意义(χ^(2)=9.503,6.648,均P<0.05)。结论在FET周期中,BMI增加会导致PCOS患者的活产率降低,早产率增加。建议超重的PCOS患者在进行辅助生殖治疗前科学减重,控制BMI在正常范围内,以获得更好的妊娠结局。Objective To explore the effect of body mass index(BMI)in frozen-thawed embryo transfer(FET)cycles on pregnancy outcomes of infertile patients with polycystic ovary syndrome(PCOS).Methods A total of 213 infertile patients with PCOS who visited Department of Reproductive Medicine of the First Affiliated Hospital of Xiamen University for FET from January 2017 to December 2020 were selected and divided into three groups according to BMI:thin group(BMI<18.5 kg/m^(2),17 cases),normal group(18.5 kg/m^(2)≤BMI<24.9 kg/m^(2),137 cases),and overweight group(BMI≥25 kg/m^(2),59 cases).The general clinical information and pregnancy outcomes in the three groups were compared.Results There were statistically significant differences in the number of gonadotropin(Gn)days,total Gn dose,estradiol(E_(2))level on the day of human chorionic gonadotropin(hCG),BMI,and basic luteinizing hormone(LH)among the three groups(P<0.05).There were statistically significant differences in the number of retrieved oocytes,live birth rate,and preterm birth rate among the three groups(P<0.05).The number of retrieved oocytes(16.52±6.21),the number of MⅡoocytes(14.39±5.59),and live birth rate(42.34%)in normal group were higher than those in overweight group[(13.97±5.88),(12.42±5.20),20.34%],preterm birth rate in normal group(12.41%)was lower than that in overweight group(37.50%),there were statistically significant differences(χ^(2)=9.503,χ^(2)=6.648,P<0.05).Live birth rate in thin group(58.82%)was higher than that in overweight group,preterm birth rate(0.00%)was lower than that in overweight group,there were statistically significant differences(χ^(2)=9.503,6.648,P<0.05).Conclusion An increase in BMI during FET cycles leads to a decrease in live birth rate and an increase in preterm birth rate in patients with PCOS.It is recommended that overweight PCOS patients should lose weight scientifically and control BMI within the normal range before undergoing assisted reproductive treatment to achieve better pregnancy outcomes.

关 键 词：体质量指数 冻融胚胎移植 多囊卵巢综合征 妊娠结局 

分 类 号：R714[医药卫生—妇产科学]