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体重指数和短期体重变化与接受辅助生殖治疗的女性的治疗结局的关系。

Body mass index and short-term weight change in relation to treatment outcomes in women undergoing assisted reproduction.

机构信息

Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA.

出版信息

Fertil Steril. 2012 Jul;98(1):109-16. doi: 10.1016/j.fertnstert.2012.04.012. Epub 2012 May 16.

Abstract

OBJECTIVE

To assess the relation between body mass index (BMI) and short-term weight change with assisted reproductive technology (ART) outcomes.

DESIGN

Prospective cohort study.

SETTING

Fertility center.

PATIENT(S): A total of 170 women undergoing 233 ART cycles.

INTERVENTION(S): Baseline BMI and short-term weight change were related to ART outcomes. Regression models accounting for repeated observations were used to adjust data for potential confounders.

MAIN OUTCOME MEASURE(S): Peak E2 levels, oocyte yield, MII yield, fertilization rate, embryo quality, postive [beta]-hCH, clinical pregnancy and live birth rates.

RESULT(S): Overweight and obesity were associated with lower live birth rates. The adjusted live birth rate (95% confidence interval) was 42% (28%-58%) among women with a BMI between 20 and 22.4 kg/m(2) and 23% (14%-36%) among overweight or obese women. Short-term weight loss was associated with a higher proportion of metaphase II (MII) oocytes retrieved. The adjusted proportion of MII eggs was 91% (87%-94%) for women who lost 3 kg or more and 86% (81%-89%) for women whose weight remained stable. This association was stronger among women who were overweight or obese at baseline. Short-term weight loss was unrelated to positive β-hCG, clinical pregnancy, or live birth rates.

CONCLUSION(S): Overweight and obesity were related to lower live birth rates in women undergoing ART. Short-term weight loss was related to higher MII yield, particularly among overweight and obese women, but unrelated to clinical outcomes.

摘要

目的

评估体重指数(BMI)与辅助生殖技术(ART)结局的短期体重变化之间的关系。

设计

前瞻性队列研究。

地点

生育中心。

患者

共 170 名接受 233 次 ART 周期的女性。

干预措施

基线 BMI 和短期体重变化与 ART 结果相关。使用考虑重复观察的回归模型来调整数据以消除潜在的混杂因素。

主要观察指标

峰值 E2 水平、卵母细胞产量、MII 产量、受精率、胚胎质量、β-hCG 阳性、临床妊娠率和活产率。

结果

超重和肥胖与较低的活产率相关。调整后的活产率(95%置信区间)在 BMI 为 20-22.4kg/m²的女性中为 42%(28%-58%),在超重或肥胖女性中为 23%(14%-36%)。短期体重减轻与获得更多中期 II 期(MII)卵母细胞有关。体重减轻 3kg 或更多的女性中 MII 卵的比例调整后为 91%(87%-94%),体重稳定的女性中为 86%(81%-89%)。这种关联在基线时超重或肥胖的女性中更为明显。短期体重减轻与β-hCG 阳性、临床妊娠或活产率无关。

结论

超重和肥胖与接受 ART 的女性活产率降低有关。短期体重减轻与更高的 MII 产量有关,尤其是在超重或肥胖的女性中,但与临床结局无关。

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