低体质指数不利于不明原因原发不孕患者人工授精诱导排卵周期妊娠结局

Low BMI is Associated with Poor OI-IUI Outcomes in Patients with Unexplained Primary Infertility

【目的】探索女方体质指数(BMI)对不明原因原发不孕女性人工授精诱导排卵周期(OI-IUI)妊娠结局的影响。【方法】回顾性分析2016年1月至2022年12月于中山大学孙逸仙纪念医院生殖中心行OI-IUI助孕的不明原因原发不孕夫妻共764个周期的临床资料。按照女方患者BMI分为3组,低BMI组(消瘦,BMI<18.5 kg/m^(2))、正常BMI组(正常体质量,18.5 kg/m^(2)≤BMI<23.0 kg/m^(2))、高BMI组(超重、肥胖,BMI≥23.0 kg/m^(2)),比较各组间一般资料以及妊娠结局。采用单因素分析和Logistic回归分析矫正混杂因素,探讨BMI与OI-IUI活产率的相关性。【结果】三组HCG阳性率(7.08%、9.74%、13.19%)、宫内妊娠率(5.51%、7.91%、13.19%)和活产率(4.72%、6.90%、12.50%)由低BMI组到高BMI组依次递增,早期流产率(14.28%、10.26%、5.26%)则是由低BMI组至高BMI组依次递减,其中高BMI组活产率明显高于低BMI组及正常BMI组,差异有统计学意义(P=0.034)。根据二元Logistic回归分析显示,BMI是影响活产的独立影响因素,与低BMI相比,高BMI可提高活产率(OR=3.15,95%CI=1.191,8.329,P=0.021)。【结论】低BMI不利于不明原因原发不孕女性OI-IUI妊娠结局,对该部分患者鼓励以健康方式进行合理增重。

【Objective】To evaluate the effect of women´s body mass index(BMI)on pregnancy outcomes of ovulation induction intrauterine insemination(OI-IUI)in patients with unexplained primary infertility.【Methods】The study includ⁃ed 764 OI-IUI cycles from January 2016 to December 2022 in reproductive center of Sun Yat-sen Memorial Hospital.Ac⁃cording to BMI,patients were divided into three groups:low BMI(BMI<18.5 kg/m^(2)),normal BMI(18.5 kg/m^(2)≤BMI<23.0 kg/m^(2)),and high BMI(BMI≥23.0 kg/m^(2)).Comparison of clinical data and pregnancy outcomes was performed be⁃tween the groups.Logistic regression was used to analyze the association between BMI and live birth rate.【Results】From the low BMI group to the high BMI group,the HCG positive rate(7.08%,9.74%,13.19%),clinical pregnancy rate(5.51%,7.91%,13.19%),and live birth rate(4.72%,6.90%,12.50%)increased.Among them,the live birth rate of the high BMI group was significantly higher than that of the low BMI group and the normal BMI group,with a statistically significant difference(P=0.034).While the early miscarriage rate(14.28%,10.26%,5.26%)decreased from the low BMI group to the high BMI group.The binary logistic regression analysis revealed that BMI was an independent factor in live birth,and high BMI resulted in a better live birth rate than low BMI(OR=3.15,95%CI=1.191-8.329,P=0.021)【.Con⁃clusion】Low BMI is associated with poor OI-IUI outcomes in patients with unexplained primary infertility.These patients are encouraged to gain weight in a healthy manner.