Rehman Rehana, Hussain Zahir, Faraz Naveed
J Ayub Med Coll Abbottabad. 2012 Jul-Dec;24(3-4):3-5.
The incidence of obesity in women of reproductive age group has encountered problems of infertility with frequent referral to reproductive clinics. In order to know whether increase in body mass index (BMI) is associated with poor reproductive outcome, current study was aimed to relate women's BMI, estradiol (E2) levels, and clinic pregnancy rates after intra cytoplasmic sperm injection (ICSI).
Quasi experimental design of 323 women was conducted from June 2010 till August 2011. Women were grouped on the basis of BMI; Group A, BMI < 18 (underweight); Group B, BMI 18-22.9 (normal weight); Group C, BMI 23-25.9 (overweight); and Group D, BMI > or = 26 (obese). Procedure of ICSI commenced by down regulation of ovaries followed by controlled ovarian stimulation. Oocyte pickup was done 36 hours after ovulation induction by hCG, eggs fertilised in vitro were graded and only blastocysts were transferred. Serum samples of basal E2, peak E2 (day of hCG administration) and mid-luteal E2 (7 days after egg collection) measured by ELISA were compared in all BMI groups. Pregnancy outcome of these was categorised as: no conception beta-hCG < 5 mlU/ml, preclinical abortion with beta-hCG > 5 mlU/ml, no cardiac activity on transvaginal scan (TVS) and clinical pregnancy with beta-hCG >5 mlU/ml and cardiac activity on trans-vaginal scan.
Obese women with BMI > or = 26 had lowest basal, peak and mid-luteal E2 with minimum clinical pregnancy rates compared to rest of the groups.
A high BMI is associated with decreased E2 levels in all phases of ovarian cycle and has a negative impact on pregnancy outcome.
育龄期女性肥胖发生率不断上升，常导致不孕问题，因而频繁前往生殖诊所就诊。为了解体重指数（BMI）升高是否与不良生殖结局相关，本研究旨在探讨女性BMI、雌二醇（E2）水平与胞浆内单精子注射（ICSI）后的临床妊娠率之间的关系。
2010年6月至2011年8月对323名女性进行了准实验设计。根据BMI对女性进行分组：A组，BMI<18（体重过轻）；B组，BMI 18-22.9（正常体重）；C组，BMI 23-25.9（超重）；D组，BMI≥26（肥胖）。ICSI程序始于卵巢的降调节，随后进行控制性卵巢刺激。在注射hCG诱导排卵36小时后进行卵母细胞采集，体外受精的卵子进行分级，仅移植囊胚。通过酶联免疫吸附测定法（ELISA）对所有BMI组的基础E2、峰值E2（注射hCG当天）和黄体中期E2（取卵后7天）的血清样本进行比较。这些患者的妊娠结局分为：未受孕（β-hCG<5 mIU/ml）、临床前流产（β-hCG>5 mIU/ml）、经阴道超声检查（TVS）未见心搏以及临床妊娠（β-hCG>5 mIU/ml且经阴道超声检查可见心搏）。
与其他组相比，BMI≥26的肥胖女性基础、峰值和黄体中期E2水平最低，临床妊娠率也最低。
高BMI与卵巢周期各阶段E2水平降低相关，对妊娠结局有负面影响。
