Objective:To investigate the effects of female body mass index on embryo development and assisted reproductive technology outcomes,aiming to provide better treatment for patients with different body mass index and pro...Objective:To investigate the effects of female body mass index on embryo development and assisted reproductive technology outcomes,aiming to provide better treatment for patients with different body mass index and provide reference for clinical treatment.Methods:The study retrospectively collected data of 3783 patients who received their first fresh embryo transfer and were ovulated by a long protocol at the Reproductive Medicine Center of the First Affiliated Hospital of Hainan Medical University from January 2015 to October 2021.Patients were divided into four groups based on body mass index(BMI):low weight group,normal weight group,overweight group and obese group.The normal weight group was used as a control to compare the basic information,assisted reproductive technology process,embryo development and assisted reproductive technology outcomes between different groups.Results:Analyzing patients'basic information,we found that the duration of infertility was significantly longer in obese women(P=0.007).Basal hormone levels in the overweight and obese groups were lower than those in the normal group(P<0.05).Basal Follicle-stimulating hormone(FSH),basal Luteinizing hormone(LH),basal Estradiol(E2),basal Progesterone(P),and anti-Mullerian hormone(AMH)in the obese group were lower than the normal weight group(P<0.05),and the number of antral follicle counting(AFC)was reduced in the obese group(P=0.011).The overweight group only showed a decrease in E2 and P levels(P<0.05).During the ART,there was a significant difference in Gonadotropin(Gn)dosage among the four groups,with the obese group was the most,followed by the overweight group,and the low weight group was the least(P<0.001).Gn days were increased in the obese group(P<0.001).LH,E2,and P on trigger day were all lower in the overweight and obese groups than in the normal weight group(P<0.05).Comparing the embryo development process,we found that the blastocysts of the obese group showed delayed development at the stages of pronuclei disappearance,four-cell and blastocyst formation(P<0.05).The ART outcomes were worse in the obese group,the clinical pregnancy rate(P=0.044)and live birth rate(P=0.036)were reduced in the obese group.After logistic regression,obesity was found to be a risk factor for clinical pregnancy(OR=0.683,95%CI:0.479-0.973,P=0.035)and live birth(OR=0.662,95%CI:0.459-0.954,P=0.027).Female age was a risk factor for biochemical pregnancy,clinical pregnancy and live birth(P<0.05).Conclusion:Female obesity prolongs the duration of infertility,causes endocrine disorders,increases Gn dosage and days,and leads to poorer assisted reproductive technology outcomes.Female obesity delays the blastocyst development process and presents as a risk factor for clinical pregnancy and live birth.展开更多
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 tota...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.展开更多
Objective:Overweight and obesity are increasingly epidemic and negatively related to reproductive outcome.The aim of this study was to investigate the advantages of a modified ultra-long downregulation protocol on pre...Objective:Overweight and obesity are increasingly epidemic and negatively related to reproductive outcome.The aim of this study was to investigate the advantages of a modified ultra-long downregulation protocol on pregnancy outcomes of patients with high body mass index(BMI)undergoingin vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI),compared to the long protocol(LP).Methods:We retrospectively analyzed the clinical data of 3,920 infertile patients at the Reproductive and Genetic Hospital of Citic-Xiangya from January 2012 to December 2017 by propensity score matching(PSM).Patients were divided into two groups:modified ultra-LP(MULP)(n=1,960)and LP(n=1,960).Results:In the MULP group,live birth rate(52.65%vs.46.79%,P<0.001,odds ratio[OR]:1.784,95%confidence interval[CI]:1.563-2.036),clinical pregnancy rate(62.50%vs.57.91%,P=0.003,OR:1.211,95%CI:1.066-1.377),and implantation rate(53.24%vs.49.65%,P=0.004,OR:1.155,95%CI:1.048-1.272)were statistically significantly higher than those of the LP group.Moreover,the cycle cancellation rates(12.70%vs.15.15%,P=0.027,OR:0.815,95%CI:0.68-0.977),abortion rates(12%vs.14.8%,P=0.046,OR:0.785,95%CI:0.619-0.996),and ectopic pregnancy rates(1.06%vs.2.11%,P=0.04,OR:0.497,95%CI:0.252-0.98)were lower than those in the LP group.Conclusion:The modified ultra-long downregulation protocol improved the pregnancy outcomes in patients with high BMI undergoing IVF/ICSI treatment,providing a potential option for physicians when deciding an optimized ovary stimulation protocol for high BMI patients.展开更多
目的:探讨育龄期女性体重指数对胚胎发育及助孕结局的影响,旨在为不同体重指数的患者提供更好的助孕治疗,为临床诊疗提供参考。方法:回顾性收集2015年1月~2021年10月在海南医学院第一附属医院生殖医学中心首次接受鲜胚移植且通过长方案...目的:探讨育龄期女性体重指数对胚胎发育及助孕结局的影响,旨在为不同体重指数的患者提供更好的助孕治疗,为临床诊疗提供参考。方法:回顾性收集2015年1月~2021年10月在海南医学院第一附属医院生殖医学中心首次接受鲜胚移植且通过长方案促排的患者资料,共3783例。按照体重指数(body mass index,BMI)将患者分为:低体重组(BMI<18.5 kg/m^(2))、正常体重组(18.5≤BMI<24 kg/m^(2))、超重组(24≤BMI<28 kg/m^(2))和肥胖组(BMI≥28 kg/m^(2))。比较四组的基本情况、助孕过程、胚胎发育以及助孕结局。结果:分析患者基本情况发现,四组女性年龄无显著差异(P>0.05),但肥胖女性的不孕时间显著延长(P=0.007)。超重及肥胖组的基础内分泌水平低于正常组(P<0.05)。肥胖组基础卵泡刺激素(follicle-stimulating hormone,FSH)、基础黄体生成素(luteinizing hormone,LH)、基础雌二醇(estradiol,E2)、基础孕酮(progesterone,P)、抗缪勒管激素(anti-mullerian hormone,AMH)均低于正常体重组(P<0.05),肥胖组基础窦卵泡数(antral follicle counting,AFC)减少(P=0.011)。超重组仅表现为E2、P水平降低(P<0.05)。在助孕过程中,肥胖组促性腺激素(gonadotropin,Gn)用量最多,超重组次之,低体重组最少(P<0.001)。肥胖组的Gn天数延长(P<0.001)。超重、肥胖组扳机日LH、E2、P均低于正常体重组(P<0.05)。比较胚胎发育过程得出,肥胖组囊胚在原核消失(time of pronuclei disappearance,tPNf)、四细胞(time of four cells,t4)及囊胚形成(time of full blastocyst,tB)阶段均出现发育延迟(P<0.05)。肥胖组助孕结局较差,表现为临床妊娠率(P=0.044)及活产率(P=0.036)降低。行二分类Logistic回归分析后发现,肥胖是临床妊娠(OR=0.683,95%CI:0.479-0.973,P=0.035)及活产(OR=0.662,95%CI:0.459-0.954,P=0.027)的危险因素。年龄为生化妊娠、临床妊娠和活产的危险因素(P<0.05)。结论:女性肥胖延长不孕时间,引起内分泌紊乱,增加Gn用量及天数。女性肥胖能延迟囊胚发育过程,为临床妊娠及活产的危险因素。展开更多
基金Hainan Provincial Science and Technology Plan(Clinical Medical Research Center)Project(No.LCYX202102)。
文摘Objective:To investigate the effects of female body mass index on embryo development and assisted reproductive technology outcomes,aiming to provide better treatment for patients with different body mass index and provide reference for clinical treatment.Methods:The study retrospectively collected data of 3783 patients who received their first fresh embryo transfer and were ovulated by a long protocol at the Reproductive Medicine Center of the First Affiliated Hospital of Hainan Medical University from January 2015 to October 2021.Patients were divided into four groups based on body mass index(BMI):low weight group,normal weight group,overweight group and obese group.The normal weight group was used as a control to compare the basic information,assisted reproductive technology process,embryo development and assisted reproductive technology outcomes between different groups.Results:Analyzing patients'basic information,we found that the duration of infertility was significantly longer in obese women(P=0.007).Basal hormone levels in the overweight and obese groups were lower than those in the normal group(P<0.05).Basal Follicle-stimulating hormone(FSH),basal Luteinizing hormone(LH),basal Estradiol(E2),basal Progesterone(P),and anti-Mullerian hormone(AMH)in the obese group were lower than the normal weight group(P<0.05),and the number of antral follicle counting(AFC)was reduced in the obese group(P=0.011).The overweight group only showed a decrease in E2 and P levels(P<0.05).During the ART,there was a significant difference in Gonadotropin(Gn)dosage among the four groups,with the obese group was the most,followed by the overweight group,and the low weight group was the least(P<0.001).Gn days were increased in the obese group(P<0.001).LH,E2,and P on trigger day were all lower in the overweight and obese groups than in the normal weight group(P<0.05).Comparing the embryo development process,we found that the blastocysts of the obese group showed delayed development at the stages of pronuclei disappearance,four-cell and blastocyst formation(P<0.05).The ART outcomes were worse in the obese group,the clinical pregnancy rate(P=0.044)and live birth rate(P=0.036)were reduced in the obese group.After logistic regression,obesity was found to be a risk factor for clinical pregnancy(OR=0.683,95%CI:0.479-0.973,P=0.035)and live birth(OR=0.662,95%CI:0.459-0.954,P=0.027).Female age was a risk factor for biochemical pregnancy,clinical pregnancy and live birth(P<0.05).Conclusion:Female obesity prolongs the duration of infertility,causes endocrine disorders,increases Gn dosage and days,and leads to poorer assisted reproductive technology outcomes.Female obesity delays the blastocyst development process and presents as a risk factor for clinical pregnancy and live birth.
基金Project supported by the Zhejiang Provincial Natural Science Foundation for Distinguished Young Scholars(No.LR16H040001)the Key Project of Science and Technology Department of Zhejiang Province(No.2018C03010)+2 种基金the Zhejiang Provincial&Ministry of Health Research Fund for Medical Sciences(Nos.WKJ-ZJ-1522 and WKJ-ZJ-1722)the National Key Technology R&D Program of China(No.2014BAI05B04)the Guangxi Natural Science Foundation(Nos.2015GXNSFBA139177,2017GXNSFAA198199,and 2017GXNSFAA198193),China
文摘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.
基金support from the National Natural Science Foundation of China(grant No.81501328)。
文摘Objective:Overweight and obesity are increasingly epidemic and negatively related to reproductive outcome.The aim of this study was to investigate the advantages of a modified ultra-long downregulation protocol on pregnancy outcomes of patients with high body mass index(BMI)undergoingin vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI),compared to the long protocol(LP).Methods:We retrospectively analyzed the clinical data of 3,920 infertile patients at the Reproductive and Genetic Hospital of Citic-Xiangya from January 2012 to December 2017 by propensity score matching(PSM).Patients were divided into two groups:modified ultra-LP(MULP)(n=1,960)and LP(n=1,960).Results:In the MULP group,live birth rate(52.65%vs.46.79%,P<0.001,odds ratio[OR]:1.784,95%confidence interval[CI]:1.563-2.036),clinical pregnancy rate(62.50%vs.57.91%,P=0.003,OR:1.211,95%CI:1.066-1.377),and implantation rate(53.24%vs.49.65%,P=0.004,OR:1.155,95%CI:1.048-1.272)were statistically significantly higher than those of the LP group.Moreover,the cycle cancellation rates(12.70%vs.15.15%,P=0.027,OR:0.815,95%CI:0.68-0.977),abortion rates(12%vs.14.8%,P=0.046,OR:0.785,95%CI:0.619-0.996),and ectopic pregnancy rates(1.06%vs.2.11%,P=0.04,OR:0.497,95%CI:0.252-0.98)were lower than those in the LP group.Conclusion:The modified ultra-long downregulation protocol improved the pregnancy outcomes in patients with high BMI undergoing IVF/ICSI treatment,providing a potential option for physicians when deciding an optimized ovary stimulation protocol for high BMI patients.
文摘目的:探讨育龄期女性体重指数对胚胎发育及助孕结局的影响,旨在为不同体重指数的患者提供更好的助孕治疗,为临床诊疗提供参考。方法:回顾性收集2015年1月~2021年10月在海南医学院第一附属医院生殖医学中心首次接受鲜胚移植且通过长方案促排的患者资料,共3783例。按照体重指数(body mass index,BMI)将患者分为:低体重组(BMI<18.5 kg/m^(2))、正常体重组(18.5≤BMI<24 kg/m^(2))、超重组(24≤BMI<28 kg/m^(2))和肥胖组(BMI≥28 kg/m^(2))。比较四组的基本情况、助孕过程、胚胎发育以及助孕结局。结果:分析患者基本情况发现,四组女性年龄无显著差异(P>0.05),但肥胖女性的不孕时间显著延长(P=0.007)。超重及肥胖组的基础内分泌水平低于正常组(P<0.05)。肥胖组基础卵泡刺激素(follicle-stimulating hormone,FSH)、基础黄体生成素(luteinizing hormone,LH)、基础雌二醇(estradiol,E2)、基础孕酮(progesterone,P)、抗缪勒管激素(anti-mullerian hormone,AMH)均低于正常体重组(P<0.05),肥胖组基础窦卵泡数(antral follicle counting,AFC)减少(P=0.011)。超重组仅表现为E2、P水平降低(P<0.05)。在助孕过程中,肥胖组促性腺激素(gonadotropin,Gn)用量最多,超重组次之,低体重组最少(P<0.001)。肥胖组的Gn天数延长(P<0.001)。超重、肥胖组扳机日LH、E2、P均低于正常体重组(P<0.05)。比较胚胎发育过程得出,肥胖组囊胚在原核消失(time of pronuclei disappearance,tPNf)、四细胞(time of four cells,t4)及囊胚形成(time of full blastocyst,tB)阶段均出现发育延迟(P<0.05)。肥胖组助孕结局较差,表现为临床妊娠率(P=0.044)及活产率(P=0.036)降低。行二分类Logistic回归分析后发现,肥胖是临床妊娠(OR=0.683,95%CI:0.479-0.973,P=0.035)及活产(OR=0.662,95%CI:0.459-0.954,P=0.027)的危险因素。年龄为生化妊娠、临床妊娠和活产的危险因素(P<0.05)。结论:女性肥胖延长不孕时间,引起内分泌紊乱,增加Gn用量及天数。女性肥胖能延迟囊胚发育过程,为临床妊娠及活产的危险因素。
