Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing, MI 48824, USA.
Hum Reprod. 2011 Jan;26(1):245-52. doi: 10.1093/humrep/deq306. Epub 2010 Nov 11.
Obesity has risen among women in the USA, including those seeking infertility treatments. In 2007, height and weight were added to the Society for Assisted Reproductive Technology Clinic Online Reporting System (SART CORS), permitting calculation of BMI (weight/height(2)) for the first time using this national dataset.
The SART CORS was used to evaluate the odds of failure to achieve a clinical intrauterine pregnancy and failure to achieve a live birth by the woman's age, BMI and oocyte source (autologous versus donor), controlling for race and ethnicity, day of embryo transfer, number of embryos transferred and infertility diagnoses. The reference population was women with normal BMI.
There were 45 163 ART embryo transfers where maternal height and weight were recorded. Increasing obesity was associated with a significant rise in failure to achieve a clinical pregnancy with the use of autologous oocytes (P< 0.0001), but no difference with the use of donor oocytes. Among women using autologous oocytes who did conceive, failure to achieve a live birth increased with increasing obesity, to a greater extent among women <35 years of age.
Higher BMI is associated with an increased failure to achieve a clinical intrauterine gestation; this risk was overcome with the use of donor oocytes. Failure to achieve a live birth increases with higher BMI, significantly with the use of autologous oocytes (P< 0.0001), and to a greater extent among women <35 years of age (P< 0.0001).
美国女性的肥胖率上升，包括寻求不孕治疗的女性。2007 年，身高和体重被添加到辅助生殖技术协会在线报告系统（SART CORS）中，首次使用这个全国性数据集计算体重指数（体重/身高的平方）。
使用 SART CORS 评估女性年龄、体重指数（BMI）和卵母细胞来源（自体与供体）对临床宫内妊娠失败和活产失败的几率，同时控制种族和民族、胚胎移植日、移植胚胎数量和不孕诊断。参考人群是 BMI 正常的女性。
有 45163 次 ART 胚胎移植记录了产妇身高和体重。随着肥胖程度的增加，使用自体卵母细胞的临床妊娠失败显著增加（P<0.0001），但使用供体卵母细胞的情况则不同。在使用自体卵母细胞受孕的女性中，随着肥胖程度的增加，活产失败的比例也在增加，在年龄<35 岁的女性中更为明显。
较高的 BMI 与临床宫内妊娠失败的风险增加相关；这种风险可以通过使用供体卵母细胞来克服。活产失败的风险随着 BMI 的增加而增加，在使用自体卵母细胞的情况下更为显著（P<0.0001），在年龄<35 岁的女性中更为明显（P<0.0001）。
