夫妻双方体重指数对体外受精结果影响

Impact of couples′ body mass index on the in vitro fertilization outcomes

目的探究夫妻双方的体重对辅助生殖结局的影响。方法回顾性分析2008年8月~2015年10月来南京医科大学附属苏州医院生殖与遗传中心接受治疗的1223例患者,根据体重指数(BMI)进行筛选分组,根据BMI将患者分为3组:正常组(18.5~23.9 kg/m2)、超重组(>23.9~27.9 kg/m2)和肥胖组(>27.9 kg/m2)。分析患者BMI与其新鲜体外受精(IVF)周期相关性。结果经过筛选女性BMI分组中最终纳入537例患者,正常组433例,超重组79例,肥胖组25例;男性BMI分组中最终纳入805例患者,其中正常组369例,超重组299例,肥胖组137例。女性BMI分组中各组年龄、女性血清基础卵泡刺激素(FSH)水平、雌二醇(E2)水平、黄体生成素(LH)水平、BMI、促性腺激素(Gn)持续时间、男性精子浓度、活力和正常形态学精子率比较,差异无统计学意义(P>0.05);超重组及肥胖组Gn剂量均高于正常体重组,差异有统计学意义(P<0.05);男性BMI分组中,各组年龄、女性血清基础FSH水平、E2水平、LH水平、BMI、Gn剂量、Gn持续时间、男性精子浓度、活力和正常形态学精子率比较,差异均无统计学意义(P>0.05);男性肥胖组的受精率、种植率和妊娠率显著低于其他两组,而流产率显著高于正常组,差异均有统计学意义(P<0.05)。结论男性BMI增加及IVF结局可能与精子DNA损伤或精子和卵母细胞间相互作用差有关,提示参与IVF治疗的夫妇,尤其是男方,需要维持适当的体重,以降低IVF结局不良的风险。

Objective To explore Lhe impacL of Lhe weighL of boLh husband and wife on assisLed reproducLive ouLcomes.Methods A reLrospecLive analysis of paLienLs undergoing LreaLmenL aL Lhe CenLer for ReproducLion and GeneLics of Lhe AffiliaLed Suzhou HospiLal of Nanjing Medical UniversiLy from AugusL 2008 Lo OcLober 2015 was conducLed.A LoLal of 1223 fresh in vitro ferLilizaLion(IVF)cycles were collecLed and grouped according Lo body mass index(BMI),Lhey were divided inLo 3 groups:normal group(BMI 18.5-23.9 kg/m2),overweighL group(BMI>23.9-27.9 kg/m2),and obese group(BMI>27.9 kg/m2).An analysis of Lhe correlaLion beLween BMI and IVF was conducLed.Results AfLer screening 537 paLienLs were finally included in female BMI group:433 cases in Lhe normal group,79 cases in Lhe overweighL group and 25 cases in Lhe obese group.805 paLienLs were evenLually included in Lhe male BMI group:369 cases in Lhe nor-mal group,299 cases in Lhe overweighL group and 137 cases in Lhe obese group.In female BMI group,Lhe age,levels of FSH,E2,LH in female serum,BMI,duraLion of Gn,Lhe concenLraLion,viLaliLy of male sperm and normal morphology sperm raLe were compared among each group,and Lhere was no sLaLisLically difference(P>0.05).The dose of Gn in overweighL group and obese group was higher Lhan LhaL in Lhe normal weighL group,and Lhe difference was sLaLisLically significanL(P<0.05).In male BMI group,Lhe age,basic levels of FSH,E2 and LH in female serum,BMI,dose and dura Lion of Gn,Lhe concenLraLion,viLaliLy of male sperm and normal morphology sperm raLe were compared among each group,and Lhere was no sLaLisLically difference(P>0.05).The ferLiliLy raLe,implanLaLion raLe and pregnancy raLe of Lhe male obesiLy group were significanLly lower Lhan Lhose of Lhe oLher Lwo groups,while Lhe aborLion raLe was significanLly higher Lhan LhaL of Lhe normal group,wiLh sLaLisLically significanL difference(P<0.05).Conclusion The correlaLion be-Lween increased male BMI and poor IVF ouLcome mighL be due Lo Lhe sperm DNA damage or poor sperm-oocyLe inLer-acLions,suggesLing LhaL couples involved in IVF Lhera-py,especially men,need Lo mainLain an appropriaLe body weighL Lo reduce poor IVF ouLcomes risk.