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肥胖对常规体外受精(IVF)中卵母细胞的数量和成熟度有不利影响,而对微刺激体外受精则没有。

Obesity adversely impacts the number and maturity of oocytes in conventional IVF not in minimal stimulation IVF.

作者信息

Zhang John J, Feret Maciej, Chang Lyndon, Yang Mingxue, Merhi Zaher

机构信息

Department of Reproductive Endocrinology and Infertility, New Hope Fertility Center , New York, NY , USA and.

出版信息

Gynecol Endocrinol. 2015 May;31(5):409-13. doi: 10.3109/09513590.2015.1014785. Epub 2015 Apr 9.

Abstract

OBJECTIVE

The objective of this study was to assess the relationship between BMI and oocyte number and maturity in participants who underwent minimal stimulation (mini-) or conventional IVF.

METHODS

Participants who underwent their first autologous cycle of either conventional (n = 219) or mini-IVF (n = 220) were divided according to their BMI to analyze IVF outcome parameters. The main outcome measure was the number of oocytes in metaphase II (MII). Secondary outcomes included the number of total oocytes retrieved, fertilized (2PN) oocytes, cleavage and blastocyst stage embryos, clinical pregnancy (CP), and live birth (LB) rates.

RESULTS

In conventional IVF, but not in mini-IVF, the number of total oocytes retrieved (14.5  ±  0.8 versus 8.8  ±  1.3) and MII oocytes (11.2 ± 0.7 versus 7.1 ± 1.1) were significantly lower in obese compared with normal BMI women. Multivariable linear regression adjusting for age, day 3 FSH, days of stimulation, and total gonadotropin dose demonstrated that BMI was an independent predictor of the number of MII oocytes in conventional IVF (p = 0.0004). Additionally, only in conventional IVF, BMI was negatively correlated with the total number of 2PN oocytes, as well as the number of cleavage stage embryos.

CONCLUSIONS

Female adiposity might impair oocyte number and maturity in conventional IVF but not in mini-IVF. These data suggest that mild ovarian stimulation might yield healthier oocytes in obese women.

摘要

目的

本研究旨在评估接受微刺激(mini-)或传统体外受精(IVF)的参与者中,体重指数(BMI)与卵母细胞数量及成熟度之间的关系。

方法

将接受首次自体传统IVF(n = 219)或mini-IVF(n = 220)周期的参与者按BMI分组,以分析IVF结局参数。主要结局指标是处于减数分裂中期II(MII)的卵母细胞数量。次要结局包括回收的卵母细胞总数、受精(2PN)卵母细胞、卵裂期和囊胚期胚胎数量、临床妊娠(CP)率和活产(LB)率。

结果

在传统IVF中,而非mini-IVF中,与正常BMI女性相比,肥胖女性回收的卵母细胞总数(14.5 ± 0.8对8.8 ± 1.3)和MII卵母细胞数量(11.2 ± 0.7对7.1 ± 1.1)显著更低。对年龄、第3天促卵泡激素(FSH)、刺激天数和总促性腺激素剂量进行多变量线性回归分析显示,BMI是传统IVF中MII卵母细胞数量的独立预测因素(p = 0.0004)。此外,仅在传统IVF中,BMI与2PN卵母细胞总数以及卵裂期胚胎数量呈负相关。

结论

女性肥胖可能会损害传统IVF中的卵母细胞数量和成熟度,但不会影响mini-IVF。这些数据表明,轻度卵巢刺激可能会使肥胖女性产生更健康的卵母细胞。

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