高BMI对多囊卵巢综合征患者IVF-ET术后妊娠结局的影响

发布时间：2019-01-27 22:09

【摘要】：目的探讨高BMI对多囊卵巢综合征(PCOS)患者行体外受精—胚胎移植(IVF-ET)后妊娠结局的影响。方法选择首次采用标准长方案行IVF-ET治疗的PCOS患者238例,根据BMI分为高BMI组156例、正常BMI组82例。所有患者均采用口服避孕药及短效促性腺激素释放激素激动剂(GnRH-a)长方案行IVF-ET治疗。比较两组IVF-ET相关指标[应用促性腺激素(Gn)总量、月经周期第2~5天基础睾酮(T)水平、注射人绒毛膜促性腺激素(h CG)日雌二醇(E2)和孕酮(P)水平、获卵数、双原核(2PN)数、优胚数]及妊娠结局指标[胚胎着床率、临床妊娠率、早期流产率、多胎妊娠率、异位妊娠率及因卵巢过渡刺激综合征(OHSS)取消移植周期率]。结果高BMI组基础T水平、Gn总量高于正常BMI组,h CG日E2及P水平低于正常BMI组(P均0.05)。高BMI组胚胎着床率低于正常BMI组,早期流产率高于正常BMI组(P均0.05)。两组其他IVF-ET及妊娠结局指标比较无统计学差异。结论高BMI的PCOS患者行IVF-ET治疗时需要更多的Gn用量;易出现移植胚胎后种植率下降、早期流产率增加等不良妊娠结局。
[Abstract]:Objective to investigate the effect of high BMI on pregnancy outcome after in vitro fertilization-embryo transfer (IVF-ET) in patients with polycystic ovary syndrome (PCOS). Methods 238 PCOS patients who were treated with IVF-ET for the first time were divided into high BMI group (156 cases) and normal BMI group (82 cases) according to BMI. All patients were treated with oral contraceptive and short acting gonadotropin releasing hormone agonist (GnRH-a) long-term regimen of IVF-ET. The relative indexes of IVF-ET were compared between the two groups [the total amount of gonadotropin (Gn), basal testosterone (T) level on the 2nd day of menstrual cycle, and the levels of estradiol (E2) and progesterone (P) on the day of injection of human chorionic gonadotropin (h CG), and the number of eggs were obtained. The number of double pronucleus (2PN), the number of superior embryos] and the outcome of pregnancy [embryo implantation rate, clinical pregnancy rate, early abortion rate, multiple pregnancy rate, ectopic pregnancy rate and the rate of canceling transplantation cycle due to ovarian transitional stimulation syndrome (OHSS)]. Results the levels of basic T and total Gn in high BMI group were higher than those in normal BMI group on, h CG day, and the E 2 and P levels were lower than those in normal BMI group (all P 0. 05). The embryo implantation rate of high BMI group was lower than that of normal BMI group, and the early abortion rate was higher than that of normal BMI group (all P 0. 05). There was no significant difference in other IVF-ET and pregnancy outcome between the two groups. Conclusion the patients with PCOS with high BMI need more Gn in the treatment of IVF-ET, and the adverse pregnancy outcomes such as the decrease of implantation rate and the increase of early abortion rate after embryo transfer are easy to occur.
【作者单位】：天津医科大学;天津市中心妇产科医院;
【分类号】：R714.8

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