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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,b LH)值A组>B组>C组,人绒毛膜促性腺激素(human chorionic gonadotropin,h CG)日LH值B组>C组(P<0.05);h CG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。
Objective To investigate the effect of body mass index (BMI) and obesity on female fertilization-embryo transfer (IVF-ET) or intracytoplasmic sperm injection (ICSI) The effects of pregnancy and outcome. Methods A total of 631 cycles of standard long-term regimen IVF-ET or ICSI from 2013 to 2014 at the Second Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from 2013 to 2014 were retrospectively analyzed. The patients were divided into three groups according to BMI: group A (low-weight group 47 (BMI≥18kg / m2); Group B (normal weight group, 440 cases): 18.5kg / m2≤BMI <24kg / m2; Group C Different overweight groups were divided into two groups: the body weight <70 kg for the H1 group (104 cases); the body weight ≥ 70 kg for the H2 group (40 cases). Compare the basic data of each group, help pregnancy and pregnancy outcomes. Results The basal follicle stimulating hormone, basal luteinizing hormone (b LH) value of group A, group B, group C, group LH of human chorionic gonadotropin (h CG) (P <0.05). The values of estradiol (E2) in group A, group B, group C, group A and group B were significantly different from those in group C (P <0.05) ; The number of oocytes in group A group B> group C, group B and group C were significantly different from group A There was statistical significance (P <0.05); cycle cancellation rate of A group> B group> C group (P <0.05). The rest of the data and overweight group subgroup data comparison showed no significant difference (P> 0.05). Conclusion Abnormal BMI will affect the outcome of IVF / ICSI assisted pregnancy. Low BMI may increase the risk of ovarian hyperstimulation syndrome, resulting in high cycle cancelation rate. Excessive BMI may affect follicular development and make LH and E2 levels too low. Decreased oocyte number and decreased oocyte quality affect embryonic development, engraftment and pregnancy outcome.