Chen Hong, Wang Wen-jun, Chen Yu-zhen, Mai Mei-qi, Ouyang Neng-yong, Chen Jing-hua, Tuo Ping
Centre of Reproduction and Infertility, The Second Affiliated Hospital of Sun-Yat-Sen University, Guangzhou 510120, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2010 May;31(5):567-71.
To investigate the impacts of body mass index (BMI) and age on in vitro fertilization-embryo transfer (IVF) and intracytoplasmic sperm injection (ICSI) treatment in infertile patients without polycystic ovary syndrome (PCOS).
A retrospective study of 1426 patients during Jun. 2001 - Nov. 2009 was carried out. Multiple regression was used to analyze the effects of BMI (low weight: BMI < 18.5 kg/m(2), normal weight: BMI 18.5 - 23.99 kg/m(2) and over weight-obesity: BMI ≥ 24 kg/m(2)) and age (young: 20 - 34 years old, eld: 35 - 45 years old) on controlled ovarian stimulation (COH) [including: dose and duration of Gn, E2 level on day of human chorionic gonadotropin (HCG) administration, number of oocytes collected and full-grown follicles], number of fertilization, cleavage, two-pronucleus, normal embryos and cryopreserved embryos and clinical pregnancy outcome.
(1) Gn dose for the patients whose age were 35 and the above, had a positive correlation with age (P < 0.001), 12.70% of the total variation of Gn dose was related to age (standardized partial regression coefficient was 0.343). (2) Estradiol level on day of HCG administration had a negative correlation with BMI in overweight-obesity patients, and so were the patients whose age were 35 and above (P value respectively lower than 0.037 and 0.018). 0.80% of the total variation of estradiol (HCG day) is related to age and overweight-obesity while age took greater proportion (standardized partial regression coefficients were 0.066 and 0.058 respectively). (3) For older patients, age appeared to have negative relationships with duration of Gn and number of oocytes collected, full-grown follicles, fertilization, cleavage, two-pronucleus, normal embryos and cryopreserved embryos (P < 0.05). (4) Compared to young-normal weight patients, the odds ratio of pregnancy in eld-low weight and eld-overweight-obesity patients were 0.482 and 0.529 (P < 0.05) respectively.
Age, but not the BMI, had significant effects on IVF/ICSI treatment. It seems that factors as losing weight before IVF or ICSI treatment effective in reducing the dose of Gn.
探讨体重指数（BMI）和年龄对无多囊卵巢综合征（PCOS）的不孕患者体外受精-胚胎移植（IVF）和卵胞浆内单精子注射（ICSI）治疗的影响。
对2001年6月至2009年11月期间的1426例患者进行回顾性研究。采用多元回归分析BMI（低体重：BMI<18.5kg/m²，正常体重：BMI 18.5-23.99kg/m²，超重-肥胖：BMI≥24kg/m²）和年龄（年轻：20-34岁，年长：35-45岁）对控制性卵巢刺激（COH）[包括：促性腺激素（Gn）的剂量和用药时间、人绒毛膜促性腺激素（HCG）注射日的雌二醇（E2）水平、采集的卵母细胞数量和成熟卵泡数量]、受精、卵裂、双原核、正常胚胎和冷冻胚胎数量以及临床妊娠结局的影响。
（1）年龄在35岁及以上患者的Gn剂量与年龄呈正相关（P<0.001），Gn剂量总变异的12.70%与年龄有关（标准化偏回归系数为0.343）。（2）超重-肥胖患者及年龄在35岁及以上患者HCG注射日的雌二醇水平与BMI呈负相关（P值分别低于0.037和0.018）。雌二醇（HCG日）总变异的0.80%与年龄和超重-肥胖有关，其中年龄占比更大（标准化偏回归系数分别为0.066和0.058）。（3）对于年长患者，年龄与Gn用药时间、采集的卵母细胞数量、成熟卵泡数量、受精、卵裂、双原核、正常胚胎和冷冻胚胎数量呈负相关（P<0.05）。（4）与年轻-正常体重患者相比，年长-低体重和年长-超重-肥胖患者的妊娠优势比分别为0.482和0.529（P<0.05）。
年龄而非BMI对IVF/ICSI治疗有显著影响。似乎在IVF或ICSI治疗前减重等因素可有效降低Gn剂量。
