体质量指数、年龄与体外受精-胚胎移植患者妊娠结局相关性研究

Correlation between body mass index, age and pregnancy outcome in patients with IVF/ICSI-ET

目的:探讨体质量指数(BMI)、年龄与体外受精-胚胎移植(IVF/ICSI-ET)患者妊娠结局的相关性,为指导临床个体化治疗提供参考依据。方法:回顾性分析2014年3月至2015年1月于上海中医药大学附属曙光医院生殖医学中心就诊的IVF/ICSI-ET患者637例。按BMI分为4组:A组(BMI<18.5kg/m2)、B组(18.5kg/m2≤BMI<24kg/m2)、C组(24kg/m2≤BMI<28kg/m2)和D组(BMI≥28kg/m2),比较各组的妊娠结局;以年龄为分层的两两比较,分析BMI、年龄与妊娠结局的关系。结果:随着BMI的增加,患者取卵周期数及移植周期数显著增多,4组比较差异有统计学意义(P<0.05);A组、B组与C组比较周期妊娠率,差异有统计学意义(P<0.05);在30~38岁的女性中,B组与C组、D组比较临床妊娠率,差异均具有统计学意义(P<0.05),OR分别为1.83、4.27,即B组的临床妊娠率是C组的1.83倍,是D组的4.27倍。结论:高BMI对IVF/ICSI-ET患者临床妊娠率产生负面影响,尤其在30~38岁年龄的女性中,高BMI是影响IVF/ICSI-ET患者妊娠率的1个危险因素。

Objective:To explore the correlation between body mass index(BMI),age and pregnancy outcome in patients with in vitro fertilization-embryo transfer(IVF-ET),and to provide reference for guiding clinical individualized treatment.Methods:A retrospective analysis of 637 patients with IVF/ICSI-ET from March 2014 to January 2015 at the Reproductive Medicine Center of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine was carried out.According to BMI,the patients were divided into four groups:A group(BMI<18.5kg/m2),B group(18.5kg/m2≤BMI<24kg/m2),C group(24kg/m2≤BMI<28kg/m2)and D group(BMI≥28kg/m2).The clinical pregnancy rate and adverse pregnancy rate were compared in each group respectively.The relationship between BMI,age and pregnancy outcome was analyzed by comparing pregnancy rates according to age stratification.Results:With the increase of BMI,the number of patients’egg-taking cycles and transplantation cycles also increased significantly.The difference between the four groups was statistically significant(P<0.05).For the comparison of the cycle pregnancy rate,the A group compared with the C group,B group compared with the C group,the difference between the groups was statistically significant(P<0.05).After stratification according to age,among the women aged 30~38 years,there were significant differences in clinical pregnancy rate between B group and C group,D group(P<0.05),and OR were 1.83 and 4.27,respectively.The clinical pregnancy rate of group B was 1.83 times that of group C and 4.27 times that of group D.Conclusion:High BMI has a negative impact on the clinical pregnancy rate of IVF/ICSI-ET patients,especially in women aged 30~38 years.High BMI is a risk factor affecting pregnancy rate in IVF/ICSI-ET patients.