摘要
目的：探讨不孕症女性体质量指数（BMI）对IVF／ICSI-ET治疗结局的影响。方法：将137l例女性不孕症患者按年龄分成≤35岁和〉35岁者，再按BMl分为4组：低体质量组（A组），BMI〈18．5kg／m2，正常体质量组（B组），BMI=18．5～23．9kg／m2，超重组（C组），BMI．24．0～27．9kg／m2，肥胖组（D组），BMI≥28kg／m2，回顾性分析其IVF／ICSI新鲜取卵周期的相关指标及治疗结局。结果：①年龄≤35岁患者中，C、D组患者Gn使用时间显著长于B组（P〈0．01）；C、D组患者Gn使用总量明显多于A、B组CP〈0．01）；C、D组患者hCG注射日血清E：水平显著低于A、B组，D组显著低于c组，差异均有统计学意义（P〈0．05）；D组患者总获卵数显著低于B、c组，差异有统计学意义（P〈O．05）；A、C、D组患者卵成熟率显著低于B组（P〈0．05），D组显著低于A、C组（P〈0．01）；C、D组患者临床妊娠率显著低于B组（P〈0．05）；C、D组患者流产率显著高于B组（P〈0．05）；各组总ET数、周期取消率、生化妊娠率及活产率差异均无统计学意义（p〉0．05）。②年龄〉35岁患者中，D组患者Gn使用时间及Gn使用总量显著高于B、C组（P〈0．05）：A组患者卵成熟率显著低于B、C和D组（P〈0．05）；其他临床指标差异均无统计学意义（P〉0．05）。结论：BMI过高可导致IVF／ICSI治疗过程中Gn使用时间延长、Gn使用总量增加、临床妊娠率降低及流产率增加等，但BMI在不同年龄组对IVF／ICSI结局影响程度不同，对年龄较小（年龄≤35岁）的影响更显著，过高的BMI对IVF的结局有一定的负面影响。
Objective： To explore the influence of female infertility body mass index （BMI） on the treatment outcomes after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer （IVF/ICSI- ET）. Methods： This retrospective study was performed on 1 371 women undergoing first cycle of standard IVF. The patients were classified into two groups by age （4 35 years old and 〉35 years old） and women in each group were classified into four groups according to their BMI, low weight group （group A）： BMI〈 18.5 kg/m2; normal weight group （group B）： BMI=18.5-23.9 kg/m2; overweight group （group C）： BMI=24.0 27.9 kg/m2; obesity group （group D）： BMI ≥ 28 kg/m2. Information regarding the treatment related index and treatment outcomes of IVF-ET was compared within these four groups. Results： 1） In age ≤35 years old group, the day of Gn stimulation in group C and group D was longer than that in group B （P〈0.01）. Amount of Gn used in group C and group D was more than that in group A and group B （P〈0.05）, the amount of Gn used in group D was significantly more than that in group C （P〈0.05）. The serum E2 level on hCG injection day in group C and group D was significantly lower than that in group A and group B, and which in group D was lower than that in group C （P〈0.05）. The number of oocytes obtained in group D was significantly less than that in group B and group C （P〈0.05）. The rate of mature oocytes in group B was significantly higher than that in group A, group C and group D （P〈0.05）, and it was significantly lower in group D than in group A and group C （P〈0.01）, the clinical pregnancy rate was significantly higher in group B than in group C and group D （P〈0.05）; the abortion rate was significantly lower in group B than in group C and group D （P〈0.05）. There was no significant difference among the 4 groups in the number of embryos transferred, the rate of cycles cancelled and live birth rate （P〉0.05）. 2） In age 〉35 years old group, the day of Gn stimulation and the amount of Gn used in group D were more than those in group B and group C （P〈0.05）. The rate of mature oocytes in group A was significantly lower than that in group B, group C and group D （P〈0.05）. There was no significant difference among the 4 groups about other clinical indicators. Conclusion： The higher BMI can lead to longer days of Gn stimulation and increase the amount of Gn used during IVF-ET. With higher BMI, the clinical pregnancy rate declined obviously and the abortion rate increased significantly. More significant influence on the group of younger （age ≤35 years old） was observed over high BMI value has a negative effect on IVF outcome.
出处
《生殖与避孕》
CAS
CSCD
2013年第8期534-540,共7页
Reproduction and Contraception
