生殖医学杂志2023，Vol.32Issue(12)：1806-1812,7.DOI:10.3969/j.issn.1004-3845.2023.12.007
体质量指数对PCOS患者IVF/ICSI妊娠及围产结局的影响
Impact of body mass index on pregnancy outcomes and perinatal outcomes of PCOS patients undergoing IVF/ICSI
摘要
Abstract
Objective:To explore the impact of body mass index(BMI)on pregnancy complications and outcomes in patients with polycystic ovary syndrome receiving IVF/ICSI assisted pregnancy treatment. Methods:The data of PCOS patients who underwent IVF/ICSI treatment at the Reproductive Center of Northwest Women's and Children's Hospital from January 2019 to December 2021 were retrospective analyzed.A total of 1 143 cycles were divided into normal weight group(18.5 kg/m2 ≤BMI＜24 kg/m2,n=461),overweight group(24 kg/m2≤BMI＜28 kg/m2,n=433),and obesity group(BMI≥28 kg/m2,n=249)based on BMI values.The general information,pregnancy complications,and pregnancy outcomes of the three groups of patients were compared.The multivariate logistic regression analysis was used to analyze the relationship between pregnancy outcomes and age,infertility years,infertility type,ovulation induction protocol,fertilization model,the number and type of embryos transferred. Results:The initial amount,total amount and days of gonadotropin(Gn)in the overweight group and obesity group were significantly higher than those in the normal weight group(P＜0.05),while the number of 2PN,available embryos,excellent embryos and blastocyst formation rate were significantly lower than those in the normal weight group(P＜0.05).The incidence of moderate to severe OHSS in the overweight group(1.73％)and the obesity group(1.25％)were significantly lower than those in the normal weight group(4.02％).The abortion rate(21.88％ vs.13.31％)and the incidence of gestational hypertension(12.50％ vs.4.33％)in the obesity group were significantly higher than those in the normal weight group(P＜0.05).The live birth rate of overweight(57.97％)and obesity group(50.20％)were significantly lower than those of normal weight group(60.74％)(P＜0.05).After adjusting for confounding factors such as age,infertility years,number and type of embryos transferred,obesity was the risk of a decrease in live birth rate[OR=0.67,95％CI(0.49,0.91),P=0.012].The age of pregnant women[OR=0.96,95％CI(0.92,0.99),P=0.003]and the transplantation of Day 5 blastocysts[OR=1.40,95％CI(1.22,1.60),P＜0.001]were also independent influencing factors for live birth rate. Conclusions:In PCOS women receiving IVF/1CSI assisted pregnancy treatment,an increase in BMI can lead to longer duration and higher doses of ovulation induction medication.At the same time,it leads to an increase in the incidence of miscarriage and gestational hypertension,and a decrease in live birth rate.Therefore,it is recommended that obese PCOS patients undergoing IVF/ICSI assisted pregnancy therapy should lose weight to improve pregnancy outcomes and reduce the occurrence of pregnancy complications.关键词
体质量指数/多囊卵巢综合征/体外受精-胚胎移植/妊娠结局Key words
Body mass index/Polycystic ovary syndrome/IVF-ET/Pregnancy outcome分类
医药卫生引用本文复制引用
洪文博,张景辰,高彩霞,范丽娟,屈鹏飞,师娟子..体质量指数对PCOS患者IVF/ICSI妊娠及围产结局的影响[J].生殖医学杂志,2023,32(12):1806-1812,7.基金项目
国家自然科学基金(82103924) （82103924）
