BMI对卵巢储备正常的不孕女性行卵泡期长方案体外受精-胚胎移植的影响

ffect of body mass index on in vitro fertilization and embryo transfer with long follicular stage and embryo transfer in infertile women with normal ovarian reserve

目的探究不同体重指数(BMI)对卵巢储备正常的不孕女性进行卵泡期长方案体外受精-胚胎移植(IVF-ET)治疗及新鲜移植周期妊娠结局的影响。方法回顾性选取2022年1月1日至12月31日于桂林市妇幼保健院生殖中心首次行卵泡期长方案IVF-ET治疗的144例卵巢储备正常的不孕女性作为研究对象。按照患者BMI分为正常组(18.0 kg/m^(2)≤BMI<24.0 kg/m^(2),n=87)、超重组(24.0 kg/m^(2)≤BMI<28.0 kg/m^(2),n=46)、肥胖组(BMI≥28 kg/m^(2),n=11)。比较各组男女双方年龄、不孕年限、抗米勒管激素(AMH)、促性腺激素(Gn)起始剂量、Gn总剂量、Gn天数、平均获卵数、2PN受精数、平均移植胚胎个数、D3优胚率、妊娠率、早期流产率、分娩率。结果三组Gn天数、平均获卵数、2PN受精数、平均移植胚胎数、D3优胚率、妊娠率、早期流产率、分娩率比较,差异无统计学意义(P>0.05);但随BMI的升高,妊娠率、分娩率逐渐下降,早期流产率逐渐升高。三组Gn起始剂量、Gn总剂量比较,差异具有统计学意义(P<0.05)。结论行IVF-ET的不孕女性在行卵泡期长方案促排时,其BMI升高会影响促排卵反应,导致Gn起始剂量及Gn总剂量增加,且妊娠率及分娩率下降,早期流产率升高。

Objective To explore the effects of different body mass index(BMI)on pregnancy outcomes of in vitro fertilization and embryo transfer(IVF-ET)with long follicular stage and fresh transfer cycle in infertile women with normal ovarian reserve.Methods A total of 144 infertile women with normal ovarian reserve who underwent IVF-ET treatment for the first time in the Reproductive Center of Guilin Maternal and Child Health Hospital from January 1 to December 31,2022 were retrospectively selected as the study objects.According to the BMI of patients,they were divided into:normal group(18.0 kg/m^(2)≤BMI<24.0 kg/m^(2),n=87),overweight group(24.0 kg/m^(2)≤BMI<28.0 kg/m^(2),n=46),obese group(BMI≥28 kg/m^(2),n=11).Male and female age,infertility years,anti-Müllerian hormone(AMH),gonadotropin(Gn)starting dose,Gn total dose,Gn days,average number of retrieved oocytes,2PN fertilization numbers,average number of embryos transferred,D3 high-quality embryo rate,pregnancy rate,early abortion rate and delivery rate were compared in each group.Results There were no significant differences in Gn days,average number of retrieved oocytes obtained,2PN fertilization numbers,average number of embryos transferred,D3 high-quality embryo rate,pregnancy rate,early abortion rate and delivery rate among the three groups(P>0.05).However,with the increase of BMI,the pregnancy rate and delivery rate gradually decreased,and the early abortion rate gradually increased.The differences of Gn starting dose,Gn total dose among the three groups were statistically significant(P<0.05).Conclusions The increase in BMI in infertile women undergoing IVF-ET may impact the ovulation induction response with long follicular stage,leading to an increase in Gn starting dose,Gn total dose,a decrease in pregnancy and delivery rates,and an increase in early abortion rates.