不同体重指数的年轻患者行IVF-D助孕结局分析

IVF-ET outcomes of young women with different body mass index

目的分析在供精体外受精-胚胎移植(IVF-D)新鲜周期中,不同体重指数的年轻女性助孕的结局。方法回顾性分析2014年1月至2015年10月在西北妇女儿童医院接受常规长方案IVF-D助孕的576例患者资料。排除可能影响结局的因素,纳入年龄≤35岁第1周期IVF-D助孕的269例患者。根据我国体重指数(BMI)参考标准,分为三组,即BMI<18.5kg/m2(n=38)、BMI 18.5~23.9(n=188)和BMI≥24(n=43)。结果 BMI≥24kg/m2者不孕年限显著增加(χ~2=10.399,P=0.006)。BMI≥24kg/m2的h CG日雌二醇水平明显低于其他两组(P=0.020)。不同BMI组,Gn时间(P=0.421)、Gn总量(P=0.252)、获卵数(P=0.287)、受精率(P=0.777)、2PN率(P=0.249)、可用胚胎率(P=0.602)、优胚率(P=0.209)和周期取消率(P=0.795)无明显差异。不同BMI组,临床妊娠率无差异(P=0.629)。与其他两组相比,BMI≥24,流产率有增高趋势(P=0.167),活产率有下降趋势(P=0.197),但没有统计学差异。结论体重指数增加不影响年轻女性IVF助孕结局。

Objective To analyze the in vitro fertilization and embryo transfer （IVF-ET） outcomes of young women with different body mass index （BMI） in fresh donor sperm cycles. Methods Retrospective study was conducted among 576 cases with conventional long GnRh-a protocol in IVF-ET between January 2014 and October 2015 in Northwest Women＇s and Children＇s Hospital. Excluding possible factors, 269 women under the age of 35 and receiving the first fresh donor sperm cycle in IVF-ET were included. According to Chinese standard of BMI, theses subjects were divided into 3 groups by BMI, group of BM1 〈 18.5（n =38） , group of BMI ranging 18.5 to 23.9 （ n = 188 ） and group of BMI ≥24 （ n = 43 ）. Results The duration of infertility was significantly longer in group of BMI ≥ 24 （ P = 0. 006 ）. E2 level on HCG day was significantly lower in group of BMI ≥24 （ P = 0. 020 ） than in other two groups. There were no significant differences among 3 groups in duration of Gn, total dose of Gn, number of retrieved oocytes, fertilization rate, 2PN rate, embryos suitable for transfer, good quality embryos and cancellation rate （P value was 0. 421, 0. 252, 0.287, 0. 777, 0. 249, 0.602, 0. 209 and 0. 795, respectively）. Clinical pregnancy rate was similar among groups （P = 0. 629）. Although there was a trend toward increasing spontaneous abortion rate （P =0. 167） and declining ongoing pregnancy rate （P =0. 197）, they were no significant differences in group of BMI≥24 . Conclusion Elevated BMI does not adversely affect in IVF outcomes in young women.