体质量指数对体外受精-胚胎移植结局的影响

Effects of body mass index on procedures and outcomes of IVF-ET

目的探讨体质量指数(BMI)对体外受精-胚胎移植(IVF-ET)或卵母细胞质内单精子显微注射(ICSI)治疗过程和结局的影响。方法将323例首次应用长方案促排卵行IVF-ET或ICSI的患者,依据BMI分为三组。A组(n=43):BMI<18.5kg/m2;B组(n=253):18.5kg/m2≤BMI≤24.9kg/m2;C组(n=27):BMI>24.9kg/m2。比较各组治疗过程中各项指标及治疗结果。结果 C组平均超促排卵天数和重组卵泡刺激素(rFSH)用量较A、B两组明显增多(P<0.05);人绒毛膜促性腺激素(hCG)注射日血清雌二醇(E2)峰值、大卵泡数量及获卵数较A、B两组明显减少(P<0.05)。三组受精率、总体周期取消率和临床妊娠率比较,差异均无统计学意义(P>0.05)。结论 BMI过高导致IVF或ICSI助孕过程中超促排卵天数和rFSH用量增加,hCG注射日E2峰值、大卵泡数和获卵数降低,但对妊娠结局无明显影响。

Objective To investigate the effects of body mass index（BMI）on procedures and outcomes of in vitro fertilization and embryo transfer（IVF-ET）or intracytoplasmic sperm injection（ICSI）.Methods Three hundred and twenty-three patients undergoing first long protocol for IVF-ET or ICSI were divided into group A（BMI18.5 kg/m2,n=43）,group B（18.5 kg/m2≤BMI≤24.9 kg/m2,n=253）and group C（BMI24.9 kg/m2,n=27）.The parameters of procedures and outcomes were compared among groups.Results Compared with group A and group B,the duration of ovarian stimulation and dose of rFSH of group C were significantly increased（P0.05）,while the peak oestradiol and number of big follicles on day of HCG injection and number of follicles collected were significantly decreased（P0.05）.There was no significant difference in the rates of fertilization,overall cancellation and clinical pregnancy among three groups（P0.05）.Conclusion Higher BMI may result in increased duration of ovarian stimulation and dose of rFSH,decreased peak oestradiol and number of big follicles on day of HCG injection and decreased number of follicles collected,while has no significant effect on pregnancy outcome.