摘要
目的探讨体质量指数(body mass index,BMI)与体质量对行体外受精/卵胞质内单精子注射-胚胎移植(in vitro fertilization/intracytoplasmic sperm injection-embryo transfer,IVF/ICSI-ET)患者早卵泡期长效长方案促排卵过程中卵巢反应性的影响,指导生殖医生在确定个体化促性腺激素(gonadotropin,Gn)启动剂量时选择更准确的指标。方法回顾性队列研究分析2014年1月至2019年12月期间于江西省妇幼保健院辅助生殖中心行IVF/ICSI-ET治疗时应用早卵泡期长效长方案且Gn启动剂量均为112.5 U的5762例患者临床资料。选择BMI中位1/5人群(BMI范围为20.70~22.03 kg/m^(2)),按照体质量分为低体质量组(<51 kg)、正常体质量组(51~56 kg)、高体质量组(>56 kg),分析三组的卵巢反应性。选择体质量中位1/5患者(体质量范围为52~55 kg),按照BMI大小分为低BMI组(<20.30 kg/m^(2))、正常BMI组(20.30~22.19 kg/m^(2))、高BMI组(>22.19 kg/m^(2)),分析三组的卵巢反应性。结果BMI中位人群按体质量大小分组时,三组Gn总剂量[1612.50(1350.00,1950.00)U比1687.50(1387.50,2100.00)U比1793.75(1443.75,2250.00)U]、人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)扳机日孕酮[0.89(0.60,1.19)μg/L比0.78(0.53,1.05)μg/L比0.69(0.50,0.92)μg/L]与雌激素水平[2569.00(1774.00,3681.00)ng/L比2208.50(1614.00,3020.52)ng/L比2018.00(1385.00,2787.00)ng/L]、IVF正常受精率[66.36%(1539/2319)比66.46%(5460/8216)比62.86%(1281/2038)]、ICSI正常受精率[74.77%(320/428)比78.31%(1368/1747)比71.34%(224/314)]差异均有统计学意义(P=0.006,P<0.001,P<0.001,P=0.008,P=0.014)。通过协方差分析平衡BMI、年龄、窦卵泡计数(antral follicle count,AFC)显示,三组获卵数差异有统计学意义(P=0.022)。体质量中位人群按BMI大小分组时,三组年龄[28(26,31)岁比29(27,32)岁比29(27,32)岁]、Gn使用总量[1725.00(1368.75,2100.00)U比1725.00(1387.50,2100.00)U比1875.00(1425.00,2300.00)U]、IVF正常受精率[66.06%(1775/2687)比65.88%(5689/86
Objective To explore the effect of body mass index(BMI)and body weight on the ovarian responsiveness of patients undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET)treatment with early follicular phase long-acting long regimen,and to instruct reproductive doctors to choose the most accurate indicators when formulating individualized starting dosage of gonadotropin(Gn).Methods A retrospective cohort study analysis of the clinical data of 5762 patients who applied the early follicular phase long-acting long regimen and the Gn starting dosage was 112.5 U during IVF/ICSI-ET treatment at the Assisted Reproductive Center of Jiangxi Maternal and Child Health Hospital from January 2014 to December 2019.Totally 1/5 patients in the middle of BMI(BMI range:20.70-22.03 kg/m^(2))were selected and divided into low weight group(<51 kg),normal weight group(51-56 kg),and high weight group(>56 kg).According to body weight,the ovarian reactivity was analyzed among the three groups.In the same way,1/5 patients in the middle of weight(weight range:52 kg to 55 kg)were divided into low BMI group(<20.30 kg/m^(2)),normal BMI group(20.30-22.19 kg/m^(2)),high BMI group(>22.19 kg/m^(2))and the ovarian reactivity of the three groups was analyzed.Results There were significant differences in total Gn used dosage[1612.50(1350.00,1950.00)U vs.1687.50(1387.50,2100.00)U vs.1793.75(1443.75,2250.00)U],progesterone level[0.89(0.60,1.19)μg/L vs.0.78(0.53,1.05)μg/L vs.0.69(0.50,0.92)μg/L]and estradiol level[2569.00(1774.00,3681.00)ng/L vs.2208.50(1614.00,3020.52)ng/L vs.2018.00(1385.00,2787.00)ng/L]on the day of human chorionic gonadotropin(hCG)injection,IVF normal fertilization rate[66.36%(1539/2319)vs.66.46%(5460/8216)vs.62.86%(1281/2038)]and ICSI normal fertilization rate[74.77%(320/428)vs.78.31%(1368/1747)vs.71.34%(224/314)]among the 1/5 patients in the middle of BMI grouped by body weight(P=0.006,P<0.001,P<0.001,P=0.008,P=0.014).Covariance analysis was used to balance BMI,age and antral follicle coun
作者
夏雷震
田莉峰
伍琼芳
Xia Leizhen;Tian Lifeng;Wu Qiongfang(The Assisted Reproductive Center,Jiangxi Maternal and Child Health Hospital,Nanchang 330006,China)
出处
《中华生殖与避孕杂志》
CAS
CSCD
北大核心
2022年第9期887-893,共7页
Chinese Journal of Reproduction and Contraception
关键词
体质量指数
受精
体外
体质量
卵巢反应性
早卵泡期长效长方案
Body mass index
Fertilization in vitro
Body weight
Ovarian response
Early follicular phase long-acting long regimen
