高体质指数对新鲜胚胎移植妊娠结局的影响

Effect of high body mass index on pregnancy outcome after fresh embryo transfer

目的探讨高体质指数(BMI)对新鲜胚胎移植临床妊娠结局的影响。方法收集生殖中心行新鲜胚胎移植的475例患者临床资料,根据BMI将患者分为2组:BMI≥24 kg·m-2 设为超重和肥胖观察组(A组,108例),16 kg·m-2 ≤BMI<24 kg·m-2设为对照组(B组,367例);比较2组临床基本情况、胚胎结局及妊娠结局的差异。结果 A组基础血清卵泡刺激素(FSH)低于B组,差异有统计学意义(P=0.015);A组正常受精率低于B组,差异均无统计学意义(P=0.008);但d3可利用胚胎率及d3优质胚胎率组间比较,差异均无统计学意义(P> 0.05);同时A组生化妊娠率(P=0.038)、临床妊娠率(P=0.048)及种植率(P=0.006)均低于B组,差异有统计学意义;A组活产率有低于B组的趋势(P=0.055);胚胎移植数目、移植的优质胚胎率以及流产率组间比较,差异均无统计学意义(P> 0.05)。结论高BMI对新鲜胚胎移植的临床妊娠结局产生不良影响,但不影响胚胎质量。

Objective To investigate the effect of high body mass index (BMI) on embryo quality and clinical pregnancy outcome after fresh embryo transfer.Methods Clinical data from 475 patients who received fresh embryo transfer in our reproductive center were collected.These patients were divided into two groups according to their BMI:observation group (Group A,BMI≥24 kg·m-2,108 cases) and control group (Group B,16 kg/m2≤BMI<24 kg·m-2,367 cases).Embryo quality and reproductive outcome were compared between the two groups.Results Basal serum FSH in group A was significantly lower than that in group B (P=0.015).The fertilization rate in group A was significantly lower than that in group B (P=0.008).However,there were no significant differences between the two groups in d3 available embryo rate and d3 good-quality embryo rate (P>0.05).Meanwhile,biochemical pregnancy rate (P=0.038),clinical pregnancy rate (P=0.048),implantation rate (P=0.006) and live birth rate (P=0.055) in group A were lower than those in group B.In addition,there was no significant difference between the two groups in miscarriage rate and transfer embryo number (P>0.05).Conclusion Overweight and obesity can impaire clinical pregnancy outcome after fresh embryo transfer,but embryo quality is not affected.