肥胖对排卵正常患者促排卵卵巢反应性的影响

Effect of obesity on the ovarian response of in vitro fertilization and embryo transfer in women with normal ovulation

目的探讨肥胖对排卵正常患者IVF-ET促排卵过程中卵巢反应性的影响。方法回顾性分析首都医科大学附属北京妇产医院2009年1月~2015年12月接受IVF-ET的、排卵正常的943例患者的所有统计学资料。按照BMI将受试者分为四组:低体重组(BMI<18.5kg/m2),正常体重组(BMI在18.5~23.9kg/m2之间),超重组(BMI在24.0~27.9kg/m2之间)和肥胖组(BMI≥28.0kg/m2),并比较各组间基线数据和卵巢反应性数据。结果 943例排卵正常患者中,低体重组患者70例,正常体重组640例,超重组192例,肥胖组41例。四组间比较,结果提示不孕年限和用药量组间差异存在统计学差异(P<0.05);组间两两比较,可见肥胖组不孕年限明显高于低体重组、正常体重组和超重组,肥胖组的用药量明显高于低体重组和正常体重组,组间差异均存在统计学意义(P<0.05)。b FSH、用药天数、获卵数和受精率组间差异均未见统计学意义(P>0.05)。结论对于排卵正常的病人而言,肥胖使其促排卵过程中用药量增加,但对其卵巢反应性没有明显影响。

Objective：To analyze the effect of obesity on the ovarian response of in vitro fertilization and embryo transfer in women with normal ovulation. Methods：Retrospective study was conducted among 943 cases with normal ovulation in IVF-ET between January 2009 and December 2015 in Beijing Obstetrics and Gynecology Hospital,Capital Medical University. According to Chinese standard of BMI,these cases were divided into 4 groups by BMI,low body weight group of BMI 18.5 kg/m^2（70 cases）,normal body weight group of BMI ranging 18.5 kg/m^2 to 23.9 kg/m^2（640 cases）,overweight group of BMI ranging 24 kg/m^2 to 27.9 kg/m^2（192 cases）and obesity group of BMI≥28 kg/m^2（41 cases）. Results：The duration of infertility was significantly higher in obesity group of BMI ≥28 kg/m^2（P=0.005）than the other groups（P〈0.05）. The total dose of Gn was significantly higher in obesity group than the low body weight group of BMI18.5 kg/m^2 and the normal body weight group of BMI ranging 18.5 kg/m^2 to 23.9 kg/m^2（P〈0.05）. There were no significant differences among 4 groups in patient′s age,basal FSH,AFC,duration of Gn,number of retrieved oocytes and fertilization rate（P value was 0.648,0.158,0.495 and 0.058,respectively）. Conclusion：Obesity increases the total dose of Gn during IVF-ET in women with normal ovulation. Obesity does not adversely affect in ovarian response of IVF-ET in women with normal ovulation.