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多囊卵巢综合征女性体外受精后,病态肥胖与较低的临床妊娠率相关。

Morbid obesity is associated with lower clinical pregnancy rates after in vitro fertilization in women with polycystic ovary syndrome.

作者信息

Jungheim Emily S, Lanzendorf Susan E, Odem Randall R, Moley Kelle H, Chang Aimee S, Ratts Valerie S

机构信息

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Washington University in Saint Louis, Saint Louis, MO 63108, USA.

出版信息

Fertil Steril. 2009 Jul;92(1):256-61. doi: 10.1016/j.fertnstert.2008.04.063. Epub 2008 Aug 9.

Abstract

OBJECTIVE

To determine whether morbid obesity is associated with decreased pregnancy and live birth rates after IVF in women with polycystic ovary syndrome (PCOS).

DESIGN

Retrospective cohort study.

SETTING

University-based fertility center.

PATIENT(S): Seventy-two women with PCOS who completed their first IVF cycle between 2001 and 2006.

INTERVENTION(S): Outcomes of IVF were compared between women with a body mass index (BMI) of <40 kg/m(2) vs. those with a BMI of > or =40 kg/m(2).

MAIN OUTCOME MEASURE(S): Clinical pregnancy rate, live birth rate.

RESULT(S): Morbidly obese women with PCOS (n = 19) had significantly lower clinical pregnancy rates after IVF than patients with PCOS who were not morbidly obese (n = 53) (32% vs. 72%, relative risk 0.44, 95% confidence interval 0.22-0.87). Their live birth rates were lower too, although this difference was not statistically significant (32% vs. 60%, relative risk 0.52, 95% confidence interval 0.26-1.05).

CONCLUSION(S): Morbid obesity is associated with lower pregnancy rates in women with PCOS after IVF, raising the question of whether weight loss may improve IVF success rates for morbidly obese PCOS patients.

摘要

目的

确定多囊卵巢综合征(PCOS)女性中,病态肥胖是否与体外受精(IVF)后的妊娠率和活产率降低有关。

设计

回顾性队列研究。

地点

大学附属医院生育中心。

患者

72例在2001年至2006年间完成首次IVF周期的PCOS女性。

干预措施

比较体重指数(BMI)<40kg/m²的女性与BMI≥40kg/m²的女性的IVF结局。

主要观察指标

临床妊娠率、活产率。

结果

患有PCOS的病态肥胖女性(n = 19)IVF后的临床妊娠率显著低于非病态肥胖的PCOS患者(n = 53)(32%对72%,相对风险0.44,95%置信区间0.22 - 0.87)。她们的活产率也较低,尽管这种差异无统计学意义(32%对60%,相对风险0.52,95%置信区间0.26 - 1.05)。

结论

病态肥胖与PCOS女性IVF后的妊娠率较低有关,这引发了一个问题,即减肥是否可能提高病态肥胖PCOS患者的IVF成功率。

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