体质指数与卵巢储备功能减退患者卵巢反应的相关性分析

Relationship between body mass index and ovarian response of in vitro fertilization and embryo transfer in women with diminished ovarian reserve

目的探讨人类辅助生育技术治疗过程中不同BMI卵巢储备功能减退(diminished ovarian reserve,DOR)患者促排卵卵巢反应的相关性。方法回顾性分析北京妇产医院2010年1月至2015年12月接受体外受精-胚胎移植(in vitro fertilization and embryo transfer,IVF-ET)治疗的、资料完整的732例卵巢储备功能减退不孕患者的临床资料。按照BMI将受试者分为低体重组(BMI<18.5 kg/m^2),正常体重组(BMI 18.5~23.9 kg/m^2),超重组(BMI 24.0~27.9kg/m^2)和肥胖组(BMI≥28.0 kg/m^2)4组。比较各组患者基础数据及促排卵卵巢反应情况。结果 732例患者中低体重组58例,正常体重组499例,超重组138例,肥胖组37例。肥胖组的Gn总量明显高于低体重组和正常体重组,组间差异有统计学意义(P<0.05)。患者年龄、不孕年限、基础卵泡刺激素(follicle-stimulating hormone,FSH)、基础雌激素(estradiol,E2)、窦卵泡数、促排天数、HCG日E2、获卵数、MⅡ卵数、可利用胚胎数、受精率、卵裂率、临床妊娠率及活产率组间差异均无统计学意义(P>0.05)。结论 BMI的增加并未明显影响DOR患者IVF-ET过程中的促排卵卵巢反应,但增加了促排卵药总量。

Objective To analyze the relationship between body mass index and ovarian response of in vitro fertil- ization and embryo transfer （IVF-ET） in women with diminished ovarian reserve. Methods This retrospective study was conducted among 732 cases with diminished ovarian reserve in IVF-ET between January 2010 and December 2015 in Bei- jing Obstetrics and Gynecology Hospital. According to Chinese standard of BMI, these cases were divided into 4 groups by BMI, low body weight group with BMI 〈 18.5 kg/m2 （58 cases）, normal body weight group with BMI 18.5-23.9 kg/m2 （499 cases）, overweight group with BMI 24-27.9 kg/m2 （138 cases） and obesity group with BMI≥28 kg/m2 （37 cases）. Re- sults The total dose of Gn was significantly higher in obesity group （P = 0.005）. There were no significant differences among the 4 groups in age, duration of infertility, basal FSH, basal E2, AFC, duration of Gn, E2 level on hCG day, number of retrieved oocytes, number of Ⅱ oocytes, number of available embryo, fertilization rate, cleavage rate, clinical preg- nancy rate and live birth rate （P value was 0.457, 0.647, 0.594, 0.375, 0.897, 0.331, 0.733, 0.975, 0.979, 0.806, 0.48, 0.189, 0.816 and 0.598, respectively ）. Conclusion Elevated BMI does not adversely affect ovarian response of IVF-ET in women with diminished ovarian reserve.