体质指数对多囊卵巢综合征患者卵胞质内单精子注射助孕结局的影响

目的探讨体质指数(BMI)对多囊卵巢综合征(PCOS)不孕症患者卵胞质内单精子注射(ICSI)结局的影响。 方法选择本院生殖中心行ICSI助孕的200例患者,包括82名PCOS患者和118名非PCOS患者,根据BMI分为非超重组(BMI＜24 kg/m²)、超重组(BMI≥24 kg/m²),PCOS患者分为非超重组47例和超重组35例,非PCOS患者分为非超重组81例和超重组37例。比较4组的一般临床特征、促性腺激素(Gn)用量、Gn时间、卵母细胞数量、成熟卵母细胞、受精率、胚胎质量、妊娠率、着床率及流产率等。 结果PCOS组超重者和非超重者LH均高于非PCOS组；PCOS组和非PCOS组超重者BMI均高于非超重者(P＜0.05)。与同组非超重亚组比较,超重亚组均Gn总量升高,日扳机E2水平下降(P＜0.05)。Gn总量、日扳机E2水平PCOS超重组低于非PCOS超重组；PCOS非超重组低于非PCOS非超重组(P＜0.05)。卵泡数、获卵数、成熟卵母细胞数PCOS非超重组高于非PCOS非超重组,PCOS超重组高于非PCOS超重组(P＜0.05)。 结论BMI的增加会增加促排卵过程中的促性腺激素使用剂量,多囊卵巢综合征患者卵泡数、获卵数高于无多囊卵巢综合征患者。

Impact of body mass index on outcome of intracytoplasmic sperm injection in patients with PCOS

AimTo investigate the effects of body mass index (BMI) on the outcome of intracytoplasmic sperm injection (ICSI) in infertility patients with polycystic ovary syndrome (PCOS). Methods200 patients with ICSI assisted pregnancy, including 82 patients with PCOS and 118 patients without PCOS, were selected from the reproductive center of our hospital and divided into non-overweight group (BMI＜24 kg/m²) and overweight group (BMI≥24 kg/m²), according to body mass index. PCOS patients were divided into non-overweight group (47 cases) and overweight group (35 cases), whereas non-PCOS patients were divided into non-overweight group (81 cases) and overweight group (37 cases). The general clinical characteristics, gonadotropin (Gn) dosage, Gn time, oocyte number, mature oocyte, fertilization rate, embryo quality, pregnancy rate, implantation rate and abortion rate of the 4 groups were compared. ResultsThe LH levels of overweight and non-overweight individuals in the PCOS group were higher than those in the non-PCOS group. The BMI of overweight individuals in both the PCOS and non-PCOS groups was higher than that of non-overweight individuals (P＜0.05). Compared with the non-overweight subgroup in the same group, the overweight subgroup showed an increase in total Gn and a decrease in daily trigger E2 levels (P＜0.05). The total amount of Gn and daily trigger E2 levels were lower in PCOS super-recombination than in non-PCOS super-recombination; PCOS non-super-recombination was lower than non-PCOS non-super-recombination (P＜0.05). The number of follicles, number of retrieved eggs, and number of mature oocytes were higher in PCOS non-super-recombination than in non-PCOS non-super-recombination, and PCOS super-recombination was higher than in non-PCOS super-recombination (P＜0.05). ConclusionThe increase of BMI will increase the dosage of gonadotropin during ovulation, and the number of follicles and eggs obtained in patients with PCOS are higher than those without PCOS.