体重指数对多囊卵巢综合征患者体外受精-胚胎移植助孕的影响

Influence of body mass index on outcomes of in vitro fertilization embryo transfer promoting gestation in patients with polycystic ovary syndrome

目的探讨体重对多囊卵巢综合征(PCOS)患者体外受精-胚胎移植助孕结局的影响。方法选取2008年8月～2015年12月在我院行体外受精-胚胎移植的患者,女方35岁以下,符合PCOS诊断标准共200对夫妇。根据女方体重指数(BMI)分组:低体重组,BMI<18.5 kg/m2,6例;体重正常组,24 kg/m2>BMI≥18.5 kg/m2,63例;超重组,28 kg/m2>BMI≥24 kg/m2,71例;肥胖组,BMI≥28 kg/m2,60例。比较各组的促性腺激素(Gn)使用时间、用量,获卵数、优胚数、临床妊娠率、活产率、流产率、卵巢过度刺激综合征(OHSS)发生率。结果肥胖组和超重组的Gn使用时间长于体重正常组,Gn用量多于体重正常组,差异均有统计学意义(P<0.05)。各组的获卵数、优胚数、妊娠率及活产率比较,差异均无统计学意义(P>0.05)。肥胖组的流产率高于其他各组,但差异无统计学意义(P>0.05)。低体重组的OHSS发生率高于体重正常组,差异有统计学意义(P<0.05)。结论对于PCOS患者,不同BMI组体外受精-胚胎移植助孕的临床结局无显著差别,肥胖和超重者的Gn需要量显著增加。低体重的PCOS者更易发生OHSS。肥胖是否增加PCOS妊娠者的流产风险还需更多的研究。

Objective To explore the influence of body mass index on outcomes of in vitro fertilization embryo transfer promoting gestation in patients with polycystic ovary syndrome(PCOS).Methods From August 2008 to December 2015,200 couples were selected who underwent in vitro fertilization embryo transfer in our hospital.The female was under 35 years old and met the PCOS diagnostic criteria.According to the women′s body mass index(BMI),they were divided into the 4 groups:low body weight group,BMI<18.5 kg/m2,6 cases;normal weight group,24 kg/m^2>BMI>18.5 kg/m^2,63 cases;overweight group,28 kg/m^2>BMI>24 kg/m^2,71 cases;obesity group,BMI>28 kg/m^2,60 cases.The use time and dosage of gonadotropin(Gn),the number of eggs obtained,the number of eugenic embryos,clinical pregnancy rate,live birth rate,abortion rate and the incidence of ovarian hyperstimulation syndrome(OHSS)were compared among inter groups.Results The use time of Gn in obesity group and overweight group was longer than that in normal weight group respectively,and the dosage of Gn in obesity group and overweight group was more than that in normal weight group respectively,and the differences were statistically significant(P<0.05).There was no significant difference in the number of eggs obtained,number of eugenic embryos,pregnancy rate and live birth rate among the groups(P>0.05).The abortion rate in obesity group was higher than that in other groups,but the differences were not statistically significant(P>0.05).The incidence of OHSS in low body weight group was higher than that in normal weight group,and the difference was statistically significant(P<0.05).Conclusion For patients with PCOS,there was no significant difference in the clinical outcomes of in vitro fertilization embryo transfer in different BMI groups,and Gn requirement in obese and overweight patients increased significantly.PCOS patients with low weight are more likely to develop OHSS.More research is needed on whether obesity increases the risk of abortion in PCOS pregnancies.