海南医学院学报2023，Vol.29Issue(24)：1870-1877,8.DOI:10.13210/j.cnki.jhmu.20230828.001
育龄期女性体重指数对胚胎发育及助孕结局的影响
Effects of female body mass index on embryo development and ART outcomes
摘要
Abstract
Objective:To investigate the effects of female body mass index on embryo development and assisted reproduc-tive 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 3 783 patients who received their first fresh embryo trans-fer 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 low weight,normal weight,overweight and obese groups based on their body mass index(BMI).The normal weight group was used as a control to compare the basic conditions,as-sisted reproductive technology process,embryo development and assisted reproductive technology outcomes between different groups.Results:Analyzing patients'basic information revealed that there was no significant difference in age among the four groups(P>0.05),but 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,fol-lowed by the overweight group,and the low weight group was the least(P<0.001).The number of days of Gn use was pro-longed 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 re-duced 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 infertili-ty,causes endocrine disorders,increases Gn dosage and days,and leads to poorer assisted reproductive technology outcomes.Fe-male obesity delays the blastocyst development process and presents as a risk factor for clinical pregnancy and live birth.关键词
体重指数/辅助生殖技术/体外受精/卵胞浆内单精子注射/延时成像技术Key words
Body mass index/Assisted reproductive technology/In vitro fertilization/Intracytoplasmic sperm injection/Time-lapse technology分类
医药卫生引用本文复制引用
王明昆,黄元华,马燕琳..育龄期女性体重指数对胚胎发育及助孕结局的影响[J].海南医学院学报,2023,29(24):1870-1877,8.基金项目
Hainan Provincial Science and Technology Plan(Clinical Medical Research Center)Project(LCYX202102) 海南省科技计划(临床医学研究中心)项目(LCYX202102) （Clinical Medical Research Center）
