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目的:探讨不孕症女性体质量指数(BMI)对IVF/ICSI-ET治疗结局的影响。方法:将1 371例女性不孕症患者按年龄分成≤35岁和>35岁者,再按BMI分为4组:低体质量组(A组),BMI<18.5 kg/m2,正常体质量组(B组),BMI=18.5~23.9 kg/m2,超重组(C组),BMI=24.0~27.9 kg/m2,肥胖组(D组),BMI≥28 kg/m2,回顾性分析其IVF/ICSI新鲜取卵周期的相关指标及治疗结局。结果:①年龄≤35岁患者中,C、D组患者Gn使用时间显著长于B组(P<0.01);C、D组患者Gn使用总量明显多于A、B组(P<0.01);C、D组患者hCG注射日血清E2水平显著低于A、B组,D组显著低于C组,差异均有统计学意义(P<0.05);D组患者总获卵数显著低于B、C组,差异有统计学意义(P<0.05);A、C、D组患者卵成熟率显著低于B组(P<0.05),D组显著低于A、C组(P<0.01);C、D组患者临床妊娠率显著低于B组(P<0.05);C、D组患者流产率显著高于B组(P<0.05);各组总ET数、周期取消率、生化妊娠率及活产率差异均无统计学意义(P>0.05)。②年龄>35岁患者中,D组患者Gn使用时间及Gn使用总量显著高于B、C组(P<0.05);A组患者卵成熟率显著低于B、C和D组(P<0.05);其他临床指标差异均无统计学意义(P>0.05)。结论:BMI过高可导致IVF/ICSI治疗过程中Gn使用时间延长、Gn使用总量增加、临床妊娠率降低及流产率增加等,但BMI在不同年龄组对IVF/ICSI结局影响程度不同,对年龄较小(年龄≤35岁)的影响更显著,过高的BMI对IVF的结局有一定的负面影响。
Objective: To investigate the effect of infertility female body mass index (BMI) on IVF / ICSI-ET treatment outcome. Methods: A total of 1 371 female infertility patients were divided into three groups according to their ages, who were ≤35 years old and> 35 years old. The patients were divided into 4 groups according to BMI: low body weight group (group A), BMI <18.5 kg / (B group), BMI = 18.5-23.9 kg / m2, overweight group (group C), BMI = 24.0-27.9 kg / m2, obesity group (group D) and BMI≥28 kg / m2. / ICSI fresh ovulation cycle related indicators and treatment outcomes. Results: ①The Gn use time of patients in group C and D was significantly longer than that in group B (P <0.01). The total Gn usage of group C and D was more than that of group A and B (P <0.01). The level of E2 in serum of group C and D on the day of hCG injection was significantly lower than that of group A and B, and the difference was statistically significant (P <0.05); the total number of oocytes in group D was significantly lower than that of group B (P <0.05). The egg maturation rate of group A, C and D was significantly lower than that of group B (P <0.05), and that of group D was significantly lower than that of group A and C (P <0.01) (P <0.05). The abortion rate in group C and group D was significantly higher than that in group B (P <0.05). The total number of ET, cycle cancellation rate, biochemical pregnancy Rate and live birth rate differences were not statistically significant (P> 0.05). ②The total Gn use time and Gn in group D were significantly higher than those in group B and C (P <0.05). The egg maturation rate in group A was significantly lower than that in groups B, C and D (P < 0.05). There was no significant difference in other clinical indexes (P> 0.05). CONCLUSIONS: Excessive BMI can lead to prolonged use of Gn, increased total Gn use, lower clinical pregnancy rates, and increased abortion rates during IVF / ICSI treatment. However, the effect of BMI on IVF / ICSI outcome in different age groups is different, The effect of younger age (≤35 years old) is more significant. Excessive BMI has a certain negative effect on the outcome of IVF.