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目的探讨体重质量指数(BMI)在体外受精-胚胎移植(IVF-ET)或卵母细胞浆内单精子显微注射(ICSI)治疗过程和结局的作用。方法将309例首次应用GnRH-a长效制剂长方案促排卵行IVF-ET或ICSI的患者,依据BMl分为三组。A组(n=49)∶BMI<18.5 kg/m2,B组(n=223)∶18.5 kg/m2≤BMI≤24.9 kg/m2;C组(n=37)∶BMI>24.9 kg/m2。比较各组患者临床治疗过程中相关指标及治疗结局。结果 C组平均超促排卵天数和Gn用量较A、B两组明显增多(P<0.05);人绒毛膜促性腺澈索(hCG)注射日血清雌二醇(E2)峰值、大卵泡数量较A、B两组明显减少(P<0.05),C组获卵数比A、B组减少但无统计学意义。三组总体周期取消率和临床妊娠率比较,差异均无统计学意义(P>0.05)。结论过高的BMI将延长IVF或ICSI助孕过程中超促排卵天数,增加Gn用量,而HCG注射日E2峰值、大卵泡数却降低,但对妊娠结局无明显影响。
Objective To explore the role of body mass index (BMI) in the course and outcome of in vitro fertilization-embryo transfer (IVF-ET) or intracytoplasmic sperm injection (ICSI) in oocytes. Methods A total of 309 patients with IVF-ET or ICSI who had long-term use of GnRH-a long-acting formulation for ovulation induction were divided into three groups according to BM1. Group A (n = 49): BMI <18.5 kg / m2, Group B (n = 223): 18.5 kg / m2≤BMI≤24.9 kg / m2; Group C (n = 37): BMI> 24.9 kg / m2. Compare the relevant indicators and the treatment outcome of clinical treatment in each group. Results The average days of superovulation and the amount of Gn in group C were significantly higher than those in groups A and B (P <0.05). The peak value of serum estradiol (E2) and the number of large follicles in human chorionic gonadotropin (hCG) A and B significantly decreased (P <0.05), and the number of oocytes in group C was less than that in group A and B, but there was no statistical significance. There was no significant difference between the three groups in overall cycle cancellation rate and clinical pregnancy rate (P> 0.05). Conclusion Excessive BMI prolongs the number of days of IVF or ICSI during pregnancy, and increases the amount of Gn. However, the peak of E2 at day of HCG injection and the number of large follicles are reduced, but there is no significant effect on pregnancy outcome.