中国组织工程研究

中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (15): 2212-2217.doi: 10.3969/j.issn.2095-4344.2016.15.012

• 组织构建细胞学实验 cytology experiments in tissue construction • 上一篇    下一篇

体质量指数对不同年龄不孕女性体外受精结局的影响

李 沛，张 静，金 萱   

  1. 南昌大学第一附属医院辅助生殖科，江西省南昌市   330006
  • 收稿日期:2016-02-07 出版日期:2016-04-08 发布日期:2016-04-08
  • 通讯作者: 金萱，博士，教授，南昌大学第一附属医院辅助生殖科，江西省南昌市 330006
  • 作者简介:李沛，女，1990年生，江西省鄱阳县人，汉族，南昌大学江西医学院在读硕士，主要从事辅助生殖研究。
  • 基金资助:

    国家自然科学基金(31160246)；江西省自然科学基金(20114BAB205011)；江西省卫生厅科学基金(20121038)；江西省教育厅一般项目基金(GJJ13146)

Effect of body mass index on outcomes of in vitro fertilization for infertile females at different ages

Li Pei, Zhang Jing, Jin Xuan   

  1. Center of Assisted Reproduction, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
  • Received:2016-02-07 Online:2016-04-08 Published:2016-04-08
  • Contact: Jin Xuan, M.D. Professor, Center of Assisted Reproduction, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
  • About author:Li Pei, Studying for master’s degree, Center of Assisted Reproduction, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
  • Supported by:

    the National Natural Science Foundation of China, No. 31160246; the Natural Science Foundation of Jiangxi Province, No. 20114BAB205011; the Scientific Foundation of Jiangxi Provincial Health Deparment, No. 20121038; General Program of Jiangxi Provincial Education Deparment, No. GJJ13146

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文题释义：
体外受精：指哺乳动物的精子和卵子在体外人工控制的环境中完成受精过程的技术，与胚胎移植技术密不可分，在生物学中，把体外受精胚胎移植到母体后获得的动物称试管动物。这项技术成功于20世纪50年代，在最近20年发展迅速，现已日趋成熟而成为一项重要而常规的动物繁殖生物技术。
不孕：医学定义为1年未采取任何避孕措施，性生活正常而没有成功妊娠。主要分为原发不孕及继发不孕。原发不孕为从未受孕；继发不孕为曾经怀孕以后又不孕。根据这种严格的定义，不孕是一种常见的问题，影响到至少10%-15%的育龄夫妇。引起不孕的发病原因分为男性不孕和女性不孕。


 

背景：体质量指数对体外受精妊娠结局的影响是存在争议的，部分学者研究认为体质量指数越大，妊娠率越低，流产率越高，而另有学者认为没影响。且体质量指数对不同年龄段妊娠结局的影响的报道很少。
目的：分析体质量指数对不同年龄女性体外受精结局的影响。
方法：收集第1次接受体外受精治疗的902例不孕患者的临床资料，先按年龄分为2组：≤ 35岁组和> 35岁组；再将2组分别按体质量指数的大小分为4组：低体质量组；正常体质量组；超重组；肥胖组。
结果与结论：随着体质量指数的增加，2个年龄组平均促性激素用量均逐渐增加(P < 0.05)。≤ 35岁组中，肥胖组人绒毛膜促性腺激素注射日雌激素水平明显低于其他各组(P < 0.05)；超重和肥胖2组空卵泡率显著高于正常体质量组(P < 0.008 23)；肥胖组受精率和临床妊娠率显著低于其他各组(P < 0.05)。> 35岁组中，肥胖组的空卵泡率高于正常体质量组(P < 0.008 23)；超重和肥胖2组受精率明显低于正常体质量组(P < 0.008 23)。2个年龄组不同体质量指数的卵裂率、周期取消率、着床率、生化妊娠率和流产率差异无显著性意义(P > 0.05)。结果说明，在低年龄组，体质量指数不仅影响了卵泡质量和受精率，而且随着体质量指数增加，临床妊娠率明显下降；而对高年龄患者，体质量指数仅对卵泡质量、胚胎质量和受精率有影响，妊娠结局并无差异。由此可知体质量指数对体外受精助孕结局有影响，且对低年龄组的助孕结局影响更显著。


中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程
ORCID: 0000-0003-2207-9103(李沛)

关键词: 组织构建, 组织工程, 体质量指数, 体外受精, 肥胖, 超重, 妊娠结局, 不孕, 年龄, 卵子, 国家自然科学基金

Abstract:

BACKGROUND: The effect of body mass index (BMI) on the outcomes of in vitro fertilization (IVF) is controversial. Some scholars suggested that the higher BMI, the lower rate of pregnancy, and the higher rate of abortion. However, some others got the different results. To data, the effects of BMI on the pregnancy outcomes in females at different ages are rarely reported.

OBJECTIVE: To explore the effect of BMI on the pregnancy outcomes of IVF for infertile women atdifferent ages. 
METHODS: A total of 902 cycles undergoing IVF were divided into two groups according to the age: ≤ or ＞ 35 years old groups. The patients in each group were then divided into four subgroups according to BMI: low weight, normal weight, excess weight, and obesity subgroups, respectively.
RESULTS AND CONCLUSION: With increasing BMI, the average dosage of gonadotropins was increased gradually in two both of age groups (P < 0.05). In the ≤ 35 years old, the levels of estrogens on the day of injecting human chorionic gonadotropin was significantly lower in obesity group than the other subgroups (P < 0.05); the rates of empty follicle in excess weight and obesity subgroups were significantly higher than that in normal weight subgroup (P < 0.008 23). The fertilization rate and clinical pregnancy rate of in obesity subgroup were significantly lower than those in the other subgroups (P < 0.05). In the > 35 years old group, the empty follicle rate in obesity subgroup was significantly higher than that in normal weight subgroup  (P < 0.008 23). Fertilization rate in excess weight and obesity subgroups was significantly lower than that in the normal weight subgroup (P < 0.008 23). There were no significant differences in cleavage rate, cycle cancellation rate, implantation rate, biochemical pregnancy rate and abortion rate between four subgroups   (P > 0.05). These findings suggest that in the females at the younger age, BMI not only affects the quality of follicles and fertilization rate; but with increasing BMI, clinical pregnancy rate is decreased obviously. However in the females at the older age, BMI only affects the follicular quality, embryo quality and fertilization rates; there are no significant differences in the outcomes of pregnancy in the four subgroups. BMI have effects on pregnancy outcomes of IVF, and the effects are much greater in the younger female group.
中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Body Mass Index, Fertilization in Vitro, Obesity, Pregnancy Outcome