超重及肥胖对女性体外受精-胚胎移植结局的影响

目的：评估超重及肥胖对女性体外受精-胚胎移植（IVF-ET）结局的影响。方法：回顾性分析2010年1月—2011年12月516例行IVF-ET助孕治疗、年龄＜38岁的女性患者的临床资料。入选患者按体质量指数（BMI）分为2组：BMI正常组（A组，BMI 18.5～24.9 kg/m2）467例；超重及肥胖组（B组，BMI≥25 kg/m2）49例。分析其IVF新鲜取卵周期的相关指标及治疗结局。结果：B组患者较A组患者促性腺激素（Gn）使用时间长和Gn用量多，人绒毛膜促性腺激素（hCG）日血清雌二醇（E2）水平低（均P＜0.05）。2组患者获卵数差异无统计学意义（P＞0.05）。A组患者卵子受精率高于B组（χ2=8.102，P=0.004），2组患者种植率、临床妊娠率及活产率差异均无统计学意义。结论：超重及肥胖可导致IVF-ET治疗过程中Gn使用时间延长、Gn用量增加，受精率降低，可能对IVF-ET结局有负面影响。

Effect of Female Overweight and Obesity on IVF-ET Outcomes

Objective: To assess the effect of female overweight and obesity on the clinical outcomes of in vitro fertilization-embryo transferation (IVF-ET). Methods：This is a retrospective study of 516 women aged ＜38 years undergoing nondonor IVF cycles in a university affiliated hospital. They were classified into two groups: the normal weight group（Group A: BMI 18.5～24.9 kg/m2, n=467） and the overweight and obese group （Group B: BMI≥25 kg/m2, n=49）. Clinical treatment and outcomes（fertilization, implantation, pregnancy, miscarriage and live birth rate） were compared. Results：The total dose of gonadotrophin（Gn） and stimulation days in group B were significantly larger than those in group A（P＜0.05）, while the E2 level on the day of hCG administration in group B was significantly lower（P＜0.05）. There were not significant differences in the number of harvested oocytes, the implantation rate, the clinical pregnancy rate and the live birth rate between two groups（P＞0.05）. Interestingly, the fertilization rate in group A was significantly higher than that in group B（χ2=8.102，P=0.004）. Conclusions：Female overweight and obesity results in the prolonged Gn stimulation, the increased dose of Gn and the lowered fertilization rate, which had negative effect on IVF outcomes.