体重对体外受精-胚胎移植妊娠结局的影响

Influence of women's weight on outcome of in vitro fertilization and embryo transfer

目的探讨在体外受精-胚胎移植（IVF-ET）周期中,女方体重对妊娠结局的影响。方法对中山大学附属第一医院生殖医学中心2005年1月至2008年3月进行2973个IVF周期和1884个卵胞浆内单精子注射（ICSI）周期进行辅助生殖的患者,年龄小于40岁,排除常见的与自然流产有关的疾病,分别进行回顾性分析。按照WHO推荐的亚洲人体重指数（BMI）分级标准,将患者分为体重过低组（BMI〈18.5）、体重正常组（BMI18.5~〈23.0）、超重组（BMI23.0~〈25.0）、肥胖组（BMI≥25.0）,分别比较IVF及ICSI患者的基本临床资料、卵子和胚胎情况、妊娠结局。结果IVF及ICSI各组患者的年龄、不孕年限、周期第次、基础内分泌水平差异无统计学意义;卵子和胚胎资料差异无统计学意义;IVF及ICSI各组的周期取消率、种植率、妊娠率差异均无统计学意义;早期流产率在ICSI各组患者中差异无统计学意义,而在IVF患者中,肥胖组早期流产率显著高于体重正常组;无论IVF还是ICSI周期,肥胖组抱婴回家率均显著低于体重正常组。结论女性肥胖增加IVF周期的早期自然流产率;并对IVF及ICSI的妊娠结局均产生负面影响。

Objective To investigate the influence of women’s weight on outcome of in vitro fertilization and embryo transfer. Methods 2973 IVF cycles and 1884 ICSI cycles were chosen. All patients were younger than 40 years old. Diseases related to miscarriage were excluded. Body mass index was graded by the criteria for Asians： underweight with18.5, normal with 18.5 to 23.0, overweight with 23.0 to25.0 and obese with ≥25.0. Separately compare the basic clinical feathers, oocyte and embryo conditions, and pregnancy outcome among different BMI-groups. Results Basic clinical feathers including ages of both female and male, duration of infertility, number of cycles, and baseline sexual hormonal levels were similar in different groups of IVF and ICSI cycles. No differences were found in oocyte and embryo conditions among different groups. However, in IVF-obese group, early miscarriage rate was significant higher and take-home baby rate was significantly lower than that in IVF-normal-BMI group. In ICSI groups, no differences were found in early miscarriage rate, while take-home baby rate was significantly lower in ICSI-obese group than in ICSI-normal-BMI group. Conclusions Obesity increases early miscarriage rate after IVF cycles, and impairs both IVF and ICSI outcomes.