Abstract：Objective To explore the effect of body mass index(BMI) on the process and outcome of in vitro fertilization(IVF) among patients with different ovarian responses.Methods We collected the clinical data of 1712 patients with IVF assisted pregnancy and fresh transplantation in the Department of Reproductive Genetics, the first hospital of Shanxi Medical University from 2014 to 2018. All the patients were divided into low response group, normal response group and high response group. Then, the patients in each group were divided into four subgroups:underweight(BMI<18.5 kg/m2), normal weight(18.5-24 kg/m2), overweight(24-28 kg/m2) and obese(BMI≥28 kg/m2). We compared pregnancy outcomes in each group. All patients with PCOS were also compared among the four groups.Results In each ovarian response group, the lowest initial dose, the shortest duration and the lowest total dose of Gn were found among underweight participants; the highest initial dose, the longest duration and the highest total dose of Gn were found among obese participants. In the normal ovarian response group, the implantation rate was the highest in the normal weight group, followed by the overweight and obese group, and the lowest was in the underweight group(P<0.05). In the high ovarian response group, the number of oocytes obtained in normal weight group was the most, followed by the overweight and obese group, while that in underweight group was the least(P<0.05), but the cycle cancellation rate in obese group was significantly lower than that in underweight, normal weight and overweight group(P<0.05). In PCOS group, the number of available embryos and the rate of embryo implantation in obese group were lower than those in normal weight group(P<0.05), and the percentage of newborns with birth weight≥4 000 g in obese group was higher(P<0.05). There was no statistically significant difference in fertilization rate, clinical pregnancy rate, live birth rate, abortion rate and cesarean section rate among the groups(P>0.05).Conclusion The duration of female infertility prolonged with BMI increased. During the process of IVF assisted pregnancy, BMI not only affects the patient′s ovulation promotion(i.e. the initial dose, use time and total dose of Gn, and the number of oocytes obtained), but also affects the number of available embryos, embryo implantation rate, cycle cancellation rate and newborn birth weight. PCOS may aggravate these negative effects. Low or high BMI may affect the outcome of assisted pregnancy.
张乾乾, 何玉洁. 体重指数对不同卵巢反应性女性首次新鲜周期IVF助孕的影响[J]. 中国生育健康杂志, 2021, 32(4): 330-336.
ZHANG Qianqian, HE Yujie. Effect of body mass index on the outcome of IVF among patients with different ovarian responses. Chinese Journal of Reproductive Health, 2021, 32(4): 330-336.
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