体外受精-胚胎移植者体重指数对最终妊娠结局的影响

Impact of body mass index on outcome of pregnancy after in vitro fertilization and embryo transfer

目的:探讨在辅助生殖体外受精(IVF)、卵胞浆内单精子注射(ICSI)周期中,患者体重指数(BMI)对治疗过程和妊娠结局的影响。方法:在应用长方案促排卵行IVF-胚胎移植(IVF-ET)周期和ICSI周期者中,选取764例为对象进行回顾性分析。根据BMI将研究对象分为体重正常组606例、超重及肥胖组158例,分别比较两组的基本资料、周期中的相关指标以及妊娠结局。结果:两组研究对象双方年龄、不孕时间、基础卵泡刺激素(FSH)水平、基础黄体生成素(LH)水平差异无统计学意义(P>0.05),两组促性腺激素(Gn)使用时间、取卵数、受精率、优质胚胎率、注射人绒毛膜促性腺激素(h CG)日内膜厚度、平均移植胚胎数、胚胎种植率、临床妊娠率、分娩率、自然流产率与异位妊娠率的差异也无统计学意义(P>0.05),而两组Gn使用总量的差异有统计学意义(P<0.05)。结论:超重及肥胖者在辅助生殖IVF/ICSI周期促排卵过程中,需要更多的Gn用量,但对妊娠结局无显著影响。

Objective： To evaluate the impact of women weight on the pregnancy outcome after in vitro fertilization（ IVF） and intracytoplasmic sperm injection-embryo transfer（ ICSI）. Methods： Our retrospective study enrolled 764 patients receiving the long protocol of IVF or ICSI. According to the body mass index（ BMI）,patients were divided into two groups. Normal weight group（ n = 606） and overweight group（ n = 158） were compared in terms of basic clinical characteristics,relative factors involved in the treatment and the last pregnancy outcome. Results： No significant differences were observed in the basic clinical characteristics between the two groups,including ages of both men and women,period of infertility and basic sexual hormonal FSH and LH levels. The mean dose of gonadotropin in the overweight group was higher than in the normal weight group（ P〈0. 05）. However,there were no significant differences in other factors such as duration of gonadotropin,number of oocytes,fertility rate,embryo quality rate,intimal thickness on the day of HCG injection,average number of embryo transfer,implantation rate,clinical pregnancy rate,parturition rate,abortion ratio and ectopic pregnancy rate. Conclusion： Overweight and obese patients require a higher gonadotropin dose in ovulation induction,but has no influence on the pregnancy outcome of the IVF / ICSI cycles.