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体重指数增加对接受体外受精的正常反应者的囊胚形成率有负面影响。

Increased body mass index negatively impacts blastocyst formation rate in normal responders undergoing in vitro fertilization.

作者信息

Comstock Ioanna A, Kim Sun, Behr Barry, Lathi Ruth B

机构信息

Obstetrics and Gynecology-Reproductive Endocrinology and Infertility, Stanford Hospital and Clinics, 900 Welch Rd Ste 350 MC 5800, Palo Alto, CA, 94304, USA.

Medical Endocrinology, Stanford Hospital and Clinics, 300 Pasteur Dr S025 MC 5103, Palo Alto, CA, 94304, USA.

出版信息

J Assist Reprod Genet. 2015 Sep;32(9):1299-304. doi: 10.1007/s10815-015-0515-1. Epub 2015 Jun 25.

Abstract

PURPOSE

The aim of this study is to investigate the effect of female BMI and metabolic dysfunction on blastocyst formation rate.

METHODS

This was a retrospective cohort study that was performed in an academic center for reproductive medicine. Patients who were normal weight, overweight with metabolic dysfunction, or obese who had ≥6 oocytes retrieved in a fresh IVF cycle were included in the study. The blastocyst formation rate was calculated from the number of ≥5 cell embryos on day 3 observed in culture until day 5 or day 6. Only good quality blastocysts were included in the calculation as defined by a morphologic grade of 3BB or better.

RESULTS

The blastocyst formation rate was significantly better in the normal-weight controls versus overweight/obese patients (57.2 versus 43.6 %, p < 0.007). There was no difference in blastocyst formation between the patients with a BMI 25-29.9 kg/m(2) with metabolic dysfunction and those with a BMI ≥30 kg/m(2).

CONCLUSION

The maternal metabolic environment has a significant impact on embryo quality as measured by blastocyst formation. A decreased blastocyst formation rate is likely a significant contributor to poorer reproductive outcomes in overweight and obese women with infertility.

摘要

目的

本研究旨在探讨女性体重指数(BMI)和代谢功能障碍对囊胚形成率的影响。

方法

这是一项在生殖医学学术中心进行的回顾性队列研究。纳入在新鲜体外受精(IVF)周期中获卵数≥6枚的体重正常、超重伴代谢功能障碍或肥胖的患者。囊胚形成率根据培养至第5天或第6天观察到的第3天≥5细胞胚胎数量计算。计算时仅纳入形态学等级为3BB或更好的优质囊胚。

结果

体重正常的对照组与超重/肥胖患者相比,囊胚形成率显著更高(57.2%对43.6%,p<0.007)。BMI为25 - 29.9kg/m²伴代谢功能障碍的患者与BMI≥30kg/m²的患者之间囊胚形成无差异。

结论

以囊胚形成衡量,母体代谢环境对胚胎质量有显著影响。囊胚形成率降低可能是超重和肥胖不孕女性生殖结局较差的一个重要因素。

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