不同BMI女性行夫精人工授精后妊娠情况分析

Analysis of the pregnancy outcomes of women with different body

目的:分析不孕女性体质量指数(BMI)与夫精人工授精结局的相关性。方法:回顾性分析2016年1月—2020年12月至南京医科大学附属淮安第一医院生殖中心行夫精人工授精治疗的432例不孕夫妇的临床资料。根据WHO制定的中国女性BMI的分类标准,将患者分为低体重组(BMI<18.5 kg/m2)49例、正常体重组(18.5 kg/m2≤BMI≤23.9 kg/m2)516例,超重组(24 kg/m2≤BMI≤27.9 kg/m2)226例和肥胖组(BMI≥28 kg/m2)63例,比较各组的妊娠结局以及治疗方案、BMI和妊娠结局的相关性。结果:低体重组、正常体重组、超重组、肥胖组的临床妊娠率分别为:18.37%、14.53%、19.03%、22.22%,四组间比较,差异无统计学意义(P>0.05);生化妊娠率分别为:20.41%、15.89%、21.68%、28.57%,四组间比较,差异有统计学意义(P<0.05);但两两比较,差异无统计学意义(P>0.05)。生化妊娠流产率分别为:10%、8.54%、12.24%、22.22%,呈上升趋势,但差异无统计学意义(P>0.05);诱导排卵组生化妊娠率20.48%,自然周期组9.93%,差异有统计学意义(P<0.05)。诱导排卵组内低体重组、正常体重组、超重组、肥胖组的生化妊娠率分别为:25.71%、17.39%、22.96%、31.03%,差异无统计学意义(P>0.05);自然周期组内低体重组、正常体重组、超重组、肥胖组的生化妊娠率分别为:7.14%、9.80%、13.33%、0.00%,差异无统计学意义(P>0.05)。不同BMI下诱导排卵周期和自然周期生化妊娠率比较,差异无统计学意义(P>0.05)。结论:肥胖并不会降低AIH助孕患者的临床妊娠率,但可能会提高患者的生化妊娠流产率。不孕患者行AIH治疗时,采用诱导排卵的方式可提高妊娠率。

Objective To explore the correlation between the body mass index and the outcome of artificial insemination by husband(AIH).Methods A retrospective analysis of the clinical data of 432 infertile couples was conducted who underwent artificial insemination by husband at the Reproductive Medicine Center of the Affiliated Huaian NO.1 People’s Hospital of Nanjing Medical University from January 2016 to December 2020.According to the classification standard of Chinese female BMI established by WHO,patients were divided into underweight group(BMI<18.5 kg/m^(2)),normal weight group(18.5 kg/m2≤BMI≤23.9 kg/m^(2)),and overweight group(24 kg/m2≤BMI≤27.9 kg/m^(2))and obesity group(BMI≥28 kg/m^(2)),compareing the pregnancy outcome of each group and the correlation between treatment plan,BMI and pregnancy outcomes.Results The clinical pregnancy rates of underweight group,normal body weight group,overweight group and obesity group were 18.37%,14.53%,19.03%and 22.22%respectively.There was no significant difference between the four groups(P>0.05);The biochemical pregnancy rates were 20.41%,15.89%,21.68%and 28.57%respectively.There was significant difference between the four groups(P<0.05);However,there was no significant difference between the any two groups(P>0.05).The biochemical pregnancy abortion rates were 10%,8.54%,12.24%and 22.22%respectively,showing an upward trend,with no significant difference(P>0.05);The biochemical pregnancy rate of induced ovulation group was 20.48%,and that of natural cycle group was 9.93%,the difference was statistically significant(P<0.05).The biochemical pregnancy rates of underweight group,normal body weight group,overweight group and obesity group were 25.71%,17.39%,22.96%and 31.03%respectively,with no significant difference(P>0.05);The biochemical pregnancy rates of underweight group,normal body weight group,overweight group and obesity group in the natural cycle group were 7.14%,9.80%,13.33%and 0.00%,respectively,with no significant difference(P>0.05).Conclusion Obesity does not reduce the clinical pregnancy rate of AIH patients,but it may increase the patient’s biochemical pregnancy abortion rate.When infertile patients are treated with AIH,ovulation induction will increase the pregnancy rate.