Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
Fertil Steril. 2012 Jul;98(1):109-16. doi: 10.1016/j.fertnstert.2012.04.012. Epub 2012 May 16.
To assess the relation between body mass index (BMI) and short-term weight change with assisted reproductive technology (ART) outcomes.
Prospective cohort study.
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.
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。
前瞻性队列研究。
生育中心。
共 170 名接受 233 次 ART 周期的女性。
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。
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。
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。
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。