体质指数对体外受精-胚胎移植结局的影响

Influence of body mass index on the outcome of IVF/ICSI cycles

目的探讨体质指数(BMI)对体外受精-胚胎移植(IVF-ET)或卵胞浆内单精子显微注射(ICSI)治疗过程及结局的影响。方法回顾性分析本中心2009年1月至2010年9月共1 201例应用长方案IVF/ICSI治疗的患者,按照世界卫生组织推荐的分组标准分为三组。其中低体质量组(A组)100例,正常体质量组(B组)973例,超重和肥胖组(C组)128例。比较各组超促排卵过程中各项指标及妊娠结局。结果 C组平均促性腺激素(Gn)用量较A、B两组明显增多(P<0.05),注射人绒毛膜促性腺激素(hCG)日血清雌二醇(E2)值较A、B两组明显减少(P<0.05)。C组与B组比较,受精率(81.0%vs.83.7%)和优胚率(47.08%vs.53.8%)明显降低(P均<0.017);A组的种植率(35.1%)低于B组(45.3%)(P<0.017)。三组在获卵数、临床妊娠率、自然流产率、异位妊娠率、周期取消率方面比较,差异均无统计学意义(P>0.05)。结论随着患者BMI的增加,Gn用量明显增多。本研究尚未发现BMI对IVF/ICSI妊娠结局有显著影响。

Objective To explore the effects of extreme body mass index（BMI） on different parameters of the in vitro fertilization（IVF） or intracytoplasmic sperm injection-embryo transfer（ICSI） treatment procedure and outcome.Methods A retrospective study was conducted on the first long protocol IVF/ICSI-ET cycle in our reproductive center from January,2009 to September,2010.A total of 1201 patients were included in the study and stratified according to the World Health Organization criteria of BMI.Underweight group A（n=100）,normal weight group B（n=973）,overweight and obese group C（n=128） were compared in regard to the parameters of controlled ovary stimulation and treatment outcomes.Results The mean dose of Gn of Group C was statistically highest（P0.05） while its E_2 value on the day of hCG injection was lowest among the three groups（P0.05）.With 81.0% vs.83.7% and 47.08% vs.53.8%,fertilization rate and embryo quality rate of Group C were much lower than those of Group B（P0.017）.Group A was associated with a significant lower implantation rate compared to Group B（P0.017）.There was no significant difference in other aspects such as retrieved oocytes numbers,clinical pregnancy rate,miscarriage rate and cycle cancellation rate（P0.05）.Conclusion An elevated BMI significantly correlates with the increased number of ampules of gonadotropins used,while no significant difference was observed of the impact of BMI on the IVF/ICSI pregnancy outcomes.