Sarais Veronica, Pagliardini Luca, Rebonato Giorgia, Papaleo Enrico, Candiani Massimo, Viganò Paola
Obstetrics and Gynecology Unit, San Raffaele Scientific Institute, 20132 Milano, Italy.
Division of Genetics and Cell Biology, San Raffaele Scientific Institute, 20132 Milano, Italy.
Nutrients. 2016 Feb 23;8(3):109. doi: 10.3390/nu8030109.
The effect of a raised body mass index (BMI) on the outcome of assisted reproduction technology (ART) still represents a controversial issue. Even less clear is whether BMI acts with a potential detrimental effect on IVF outcomes via a deleterious effect on innate quality of oocytes or on the environmental milieu within the uterus. With the aim to better understand the mechanisms underlying the potential deleterious effect of an increased BMI on IVF outcomes, we have evaluated the effects of female BMI on number and quality of retrieved oocytes, fertilization rate, embryo score and incidences of ongoing pregnancy and live births among couples undergoing IVF in an Italian population. Data from 1602 women who underwent their first IVF cycle were retrospectively analyzed. A significantly reduced percentage of mature oocytes when comparing obese (BMI ≥ 30 kg/m²) and normal-weight patients (BMI = 18.50-24.99 kg/m²) was found. After adjusting for maternal age and other confounders, odds for ongoing pregnancy rate showed no differences across different BMI categories. However, a significant increased odds ratio (OR) could be observed for miscarriage rate in patients with BMI ≥ 25 (OR = 2.5; p = 0.04). These results should be taken into account in order to define optimal strategies for overweight and obese patients referring to ART procedures.
体重指数(BMI)升高对辅助生殖技术(ART)结局的影响仍是一个有争议的问题。BMI是否通过对卵母细胞的内在质量或子宫内环境产生有害影响而对体外受精(IVF)结局产生潜在有害作用,这一点甚至更不清楚。为了更好地理解BMI升高对IVF结局产生潜在有害作用的潜在机制,我们评估了意大利人群中接受IVF的夫妇中女性BMI对回收的卵母细胞数量和质量、受精率、胚胎评分以及持续妊娠和活产发生率的影响。对1602名接受首次IVF周期的女性的数据进行了回顾性分析。与肥胖(BMI≥30kg/m²)和正常体重患者(BMI=18.50-24.99kg/m²)相比,发现成熟卵母细胞的百分比显著降低。在调整了产妇年龄和其他混杂因素后,不同BMI类别之间的持续妊娠率几率没有差异。然而,BMI≥25的患者流产率的优势比(OR)显著增加(OR=2.5;p=0.04)。在为超重和肥胖患者制定关于ART程序的最佳策略时,应考虑这些结果。