PCOS不孕症患者体质指数与宫腔内人工授精失败的关系探讨  

Correlation between the body mass index of infertility patients with polycystic ovary syndrome and their failure of the intrauterine artificial insemination

作　　者：孙云青 慈丽娜 陈秀改 石国素 崔妍 SUN Yunqing;CI Lina;CHEN Xiugai;SHI Guosu;CUI Yan(Xingtai Central Hospital,,Xingtai,Hebei Province,054000)

机构地区：[1]河北省邢台市中心医院,054000

出　　处：《中国计划生育学杂志》2025年第2期459-463,共5页Chinese Journal of Family Planning

基　　金：邢台市重点研发计划自筹项目(2022ZC149)。

摘　　要：目的:探讨多囊卵巢综合征(PCOS)不孕症患者体质指数(BMI)与宫腔内人工授精(IUI)失败的关系。方法:回顾性分析本院2019年3月-2022年12月接收的首次行IUI助孕的PCOS不孕症患者155例(234周期)临床资料,依据患者BMI分为正常组[18.52kg/m^(2)≤BMI<24kg/m^(2),70例(101周期)],超重组[BMI≥24kg/m^(2),85例(133周期)]。比较两组临床基础资料、促排卵及妊娠情况,多因素logistic回归分析BMI对IUI临床妊娠和早期流产的影响,Spearman相关系数分析IUI妊娠结局与BMI的关系。结果:两组年龄、不孕时间、BMI、卵泡雌激素水平等均有差异,与正常组相较,超重组促排卵天数更长,自然排卵周期更少,临床妊娠率更低,早期流产率更高(均P<0.05);多因素logistic回归分析显示,PCOS不孕症患者年龄大(OR=0.457,95%CI 0.371~0.564,P<0.001)、BMI高(OR=0.403,95%CI 0.243~0.666,P=0.004)为临床妊娠独立风险因素,年龄大(OR=1.097,95%CI 1.045~1.153,P<0.001)、BMI高(OR=1.093,95%CI 1.037~1.152,P=0.001)也为早期流产的独立风险因素;Spearman相关系数分析显示,BMI与IUI临床妊娠率呈负相关(r=-0.536,P<0.05),BMI与IUI早期流产率呈正相关(r=0.527,P<0.05)。结论:高BMI与PCOS不孕症患者IUI失败具有相关性,与IUI临床妊娠率和早期流产率也相关,应在PCOS患者行IUI前控制BMI,以降低IUI不良结局风险。Objective: To explore the correlation between the body mass index(BMI) of infertility patients with polycystic ovary syndrome(PCOS) and their failure of the intrauterine artificial insemination(IUI). Methods: The clinical data of 155 infertility patients(234 cycles) with PCOS who received the first time IUI for assisted pregnancy in the hospital from March 2019 to December 2022 were analyzed retrospectively. According to the BMI of the patients, these patients were divided into group A(70 cases(101 cycles) with normal BMI, 18.52kg/m^(2)≤BMI<24kg/m^(2)) and group B(85 cases(133 cycles) with overweight BMI, BMI≥24kg/m^(2)).The clinical basic data, the ovulation induction and the pregnancy status of the patients were compared between the two groups. Multivariate logistic regression analysis was applied to analyze the influence of the BMI value of the patients on their clinical pregnancy and early abortion after IUI. Spearman correlation coefficient was adopted to analyze the correlation between the pregnancy outcomes of the patients after IUI and their BMI value. Results: There were significant differences in the age, the duration of infertility, the BMI value and the follicle estrogen level of the patients between the two groups. Compared with those of the patients in group A, the patients in group B had longer duration of ovulation induction, fewer natural ovulation cycles, lower clinical pregnancy rate and higher early abortion rate(all P<0.05). Multivariate logistic regression analysis showed that the advanced age(OR=0.457, 95%CI: 0.371-0.564, P<0.001) and the higher BMI value(OR=0.403,95%CI:0.243-0.666,P=0.004)of the infertility patients with PCOS were the independent risk factors of their clinical pregnancy.The advanced age(OR=1.097,95%CI:1.045-1.153,P<0.001)and the higher BMI value(OR=1.093,95%CI:1.037-1.152,P=0.001)of the infertility patients with PCOS were also the independent risk factors of their early abortion.Spearman correlation coefficient analysis showed that the BMI value of the infertility pati

关 键 词：多囊卵巢综合征不孕症 体质指数 宫腔内人工授精 妊娠结局 相关性 

分 类 号：R711.75[医药卫生—妇产科学] R711.6[医药卫生—临床医学]