[1]李亨利,田东梅,庄静,等.体质量指数及肥胖对体外受精/卵胞浆内单精子 注射周期助孕及结局的影响[J].中国计划生育和妇产科,2017,(2):60-63.
　LI Heng-li,TIAN Dong-mei,ZHUANG Jing,et al.Effects of body mass indexes and obesity on procedures and outcomes of IVF/ICSI[J].Chinese Journal of Family Planning & Gynecotokology,2017,(2):60-63.
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体质量指数及肥胖对体外受精/卵胞浆内单精子 注射周期助孕及结局的影响
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2017年2期
页码:
60-63
栏目:
论著与临床
出版日期:
2017-02-25

文章信息/Info

Title:
Effects of body mass indexes and obesity on procedures and outcomes of IVF/ICSI
作者:
李亨利; 田东梅; 庄静; 杜娟; 李莉; 朱明辉*
成都中医药大学
Author(s):
LI Heng-li;  TIAN Dong-mei;  ZHUANG Jing;  DU Juan;  LI Li;  ZHU Ming-hui*
Reproductive Medical Center, The Second Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu Sichuan 610041, P.R.China
关键词:
体质量指数; 肥胖; 体外受精-胚胎移植; 卵胞浆内单精子注射; 妊娠率
Keywords:
body mass index; obesity; IVF-ET; ICSI; pregnancy rate
分类号:
R 711.6
摘要:
目的探讨体质量指数(body mass index，BMI)及肥胖对女性体外受精-胚胎移植(in vitro fertilization-embryo transfer，IVF-ET)或卵胞浆内单精子注射(intracytoplasmic sperm injection，ICSI)治疗周期助孕及结局的影响。方法回顾性分析成都中医药大学第二附属医院2013~2014年25~35岁行标准长方案IVF-ET或ICSI治疗共631个周期，按照BMI不同分为3组：A组(低体重组47例):BMI<185kg/m2;B组(正常体重组440例):185 kg/m2≤BMI<24kg/m2;C组(超重组144例）:BMI≥24kg/m2；再根据体重的不同将超重组分为两组: 体重<70 kg 为H1组(104例); 体重≥70 kg为H2组(40例)。比较各组基础数据、助孕及妊娠结局。结果3组间基础卵泡刺激素、基础黄体生成素(basal luteinizing hormone，bLH)值A组>B组>C组，人绒毛膜促性腺激素（human chorionic gonadotropin, hCG）日LH值B组>C组(P<005)；hCG日雌二醇(estradiol，E2)值A组>B组>C组，A组、B组与C组比较，差异有统计学意义(P<005)；获卵数A组B组>C组，B组、C组与A组比较差异有统计学意义(P<005)；周期取消率A组>B组>C组(P<005)。其余资料及超重组亚组各组资料比较差异均无统计学意义(P>005)。结论BMI异常将影响IVF/ICSI助孕治疗结局，低BMI会增加卵巢过度刺激综合征风险，致周期取消率高，BMI过高可影响卵泡发育和使晚卵泡期LH、E2水平过低，使获卵数减少和卵母细胞质量下降，进而影响胚胎发育、植入和妊娠结局。
Abstract:
ObjectiveTo explore the effects of body mass index (BMI) and obesity on procedures and outcomes of in vitro fertilization and embryo transfer (IVF-ET)/intracytoplasmic sperm injection (ICSI).MethodsA retrospective study was conducted on 631 patients ranging from age 25 to 35 with the long protocol IVF/ICSI-ET cycle in The Second Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from January 2013 to December 2014. Patients were divided into three groups according to BMI： group A (underweight group， n=47):BMI<18.5kg/m2;group B(normal weight group， n=440):18.5g/m2≤BMI<24kg/m2; group C (overweight group， n=144): BMI≥24kg/m2. The overweight group was further divided by weight into two groups: group H1 (weight<70kg，n=104); group H2 (weight≥70kg ，n=40). The basic clinic data, treatment and pregnancy outcomes were compared among the groups. ResultsComparing the basic FSH and LH ， A>B>C(P<005),the level of LH on the day of hCG injection of group C was significantly lower compared with group B (P<005),and the peak oestradiol on that day in group C was significantly lower compared with the other two groups(P<005).The number of retrieved oocytes in group C was lower than group A (P<005).The diploid number of fertilization (2PN) in group A was significantly higher than the other two groups(P<005).The rate of cancellation resulting of ovarian hyperstimulation syndrome （OHSS） among three groups were A>B>C(P<005).ConclusionBMI abnormalities will affect IVF/ICSI outcomes. Low BMI will increase the risk of OHSS, causing a high rate of cancellation of the cycle. High BMI does not only affect the follicular development,but also lead to lower LH and E2 value in late follicle phase，decreasing the number of retrieved oocytes and affecting quality of oocytes, thus influence the embryo development, implantation and pregnancy outcome. 【Key

参考文献/References:

［1］钟俊敏，杨冬梓肥胖对女性生殖和代谢的影响 ［J］国际妇产科学杂志，2008，35（1）：67-68, 76 ［2］中国成人超重和肥胖症预防指南［S］.中华人民共和国疾病控制司，2003:3-4. ［3］杨玉玲，侯丽辉，吴效科肥胖与女性不孕症关系的研究进展 ［J］中国妇幼健康研究，2008，19（1）：69-71 ［4］WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies ［J］. Lancet, 2004, 363(943): 157-163. ［5］Steinkampf P, Hammond R, Nichols E, et al. Effect of obesity on recombinant follicle-stimulating hormone absorption: subcutaneous versus intramuscular administration ［J］. Fertil Steril, 2003, 80(1): 99-102. ［6］关小红，张爱军，陆小溦，等体质量指数对体外受精-胚胎移植结局的影响 ［J］上海交通大学学报（医学版），2010，30（5）：597-600 ［7］Fedorcsák Péter, Dale Olav, Storeng Ritsa, et al. Impact of overweight and underweight on assisted reproduction treatment ［J］. Hum Reprod, 2004, 19(11): 2523-2528. ［8］程昭霞，谭季春，曲文玉，等患者体重对体外受精-胚胎移植结局的影响 ［J］中国妇幼保健，2007，22（15）：2101-2103

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备注/Memo

备注/Memo:
成都市科技局科技惠民项目（项目编号：2014-HM01-00247-SF）
更新日期/Last Update: 2017-02-25