Effects of body mass index on the outcomes of in vitro fertilization in Chinese patients with polycystic ovary syndrome: a retrospective cohort study

体重指数对中国多囊卵巢综合征患者体外受精胚胎移植结局的影响:一项回顾性队列研究(英文)

Objective: To investigate the effects of body mass index(BMI) on the outcomes of in vitro fertilization(IVF) in Chinese patients with polycystic ovary syndrome(PCOS). Methods: In the retrospective cohort study, a total of 1074 patients with PCOS undergoing IVF between April 2010 and May 2017 in two reproductive medicine centers, respectively in eastern China(Women's Hospital, School of Medicine, Zhejiang University, Zhejiang Province) and in southern China(Maternal and Child Health Care Hospital of Liuzhou, Guangxi Province), were included. The patients were divided into four groups according to the recommended Chinese BMI cut-off points: underweight(BMI<18.5kg/m^2), normal weight(18.5kg/m^2≤BMI<24.0kg/m^2), overweight(24.0kg/m^2≤BMI<28.0kg/m^2), and obese(BMI≥28.0kg/m2). The basic characteristics of the PCOS patients, the details of IVF treatment, and the pregnancy outcomes were collected. Main results: There were no significant differences among the normal weight, overweight, and obese PCOS patients undergoing IVF on the biochemical pregnancy rate, clinical pregnancy rate, miscarriage rate, live birth rate, or term delivery rate(P>0.05), although the overweight and obese PCOS patients required more gonadotropin(Gn)(P<0.001) as well as longer stimulation period(P<0.001), and got less retrieved oocytes(P<0.05) and fertilized oocytes(P<0.05). The underweight PCOS patients required less Gn(P<0.05) and achieved higher live birth rate and term delivery rate(P<0.05), compared with the normal weight PCOS patients. Conclusions: High BMI had no negative effects on the outcomes of IVF in Chinese patients with PCOS; however, the conclusion may seem a little limited due to the retrospective design and the potential bias.

目的:探讨体重指数对中国多囊卵巢综合征(PCOS)患者体外受精胚胎移植结局的影响。创新点:本研究是一项多中心大样本研究,纳入了华东、华南两家生殖中心的患者;本研究根据中国体重指数(BMI)分界点进行分组,而非国际BMI分界点,得出的结论更加适合中国或者亚洲人方法:此项回顾性研究纳入2010年4月到2017年5月分别在华东、华南两家生殖中心进行体外受精胚胎移植的患者共1074例。根据推荐的中国BMI分界点,患者被分成四组:低体重组(BMI<18.5Kg/m^2),正常体重组(18.5kg/m^2≤BMI<24.0kg/m^2),超重组(24.0kg/m^2≤BMI<28.0kg/m^2)和肥胖组(BMI≥28.0kg/m^2)。比较各组间的基本信息、体外受精情况和妊娠结局。结论:高BMI对中国PCOS患者的体外受精胚胎移植结局没有不利影响。因为本研究是回顾性研究及一些潜在的偏差,所以此结论可能存在一定的局限性。