体质量指数对多囊卵巢综合征患者体外授精-胚胎移植结局的影响

Impact of body mass index on outcome of in vitro fertilization-embryo transfer in patients with polycystic ovarian syndrome

目的比较不同体质量指数（BMI）的多囊卵巢综合征（PCOS）患者体外授精-胚胎移植（IVF—ET）的治疗结局。方法87例接受IVF—ET治疗的PCOS患者，根据BMI分4组：A组BMI〈20kg／m^2，B组20～22．9kg／m^2，C组23～24．9kg／m^2，D组≥25kg／m^2。比较各组超排卵周期的基本资料、胚胎实验室数据及妊娠结局。结果D组促性腺激素用量与A组和B组相比均显著增加（P=0．01和P=0．037）。D组有效胚胎数与A、B、C三组相比均显著减少（分别为P=0．006，P=0．020和P=0．033）。各组临床妊娠率、流产率、活产率比较，差异均无统计学意义（P〉0．05）。结论随着PCOS患者BMI的增大，促性腺激素用量增加；当BMI≥25kg／m^2时，有效胚胎数减少。

Objective To compare the clinical outcomes of in vitro fertilization-embryo transfer （IVF-ET） in polycystic ovary syndrome （PCOS） patients with different body mass index （BMI）. Methods Eighty-seven PCOS patients who received IVF-ET were classified into four groups according to BMI ： group A, BMI 〈 20 kg/m^2 ; group B, BMI 20 - 22.9 kg/m^2; group C, 23 -24.9 kg/m^2 ; group D, 〉125 kg/m^2. The clinical characteristics, embryological data and pregnancy outcomes were compared. Results Higher doses of gonadotropins were used in group D compared with group A and group B （P =0.010 and P =0. 037）. Number of usable embryo was significant lower in group D compared with group A,B and C（P = 0. 006, P=0. 020 and P =0. 033, respectively）. There was no significant difference among four groups in clinical pregnancy rate, miscarriage rate and live birth rate （P 〉 0.05）. Conclusion The doses of gonadotropins are increased in PCOS patients with increasing BMI. The number of usable embryo is significant decreased in PCOS patients with BMI ≥25 kg/m^2.