体外受精/胞浆内单精子注射周期中肥胖导致的卵母细胞变小：一项前瞻性研究。
Obesity results with smaller oocyte in in vitro fertilization/intracytoplasmic sperm injection cycles-a prospective study.
机构信息
IVF Unit, Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Ruth and Bruce Rappaport School of Medicine, The Technion - Israel Institute of Technology, Haifa, Israel.
出版信息
J Assist Reprod Genet. 2017 Sep;34(9):1145-1151. doi: 10.1007/s10815-017-0975-6. Epub 2017 Jun 17.
BACKGROUND
Obesity is associated with several fertility disorders. This prospective cohort study was designed to evaluate the effect of body mass index (BMI) (kg/m) on oocyte diameter and treatment.
METHODS
Women undergoing in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) were enrolled in the study. They were divided into two groups according to BMI: obese (BMI > 30) and normal weight (BMI < 25). Mature oocytes were evaluated according to total diameter, zona pellucida, and oolema diameters.
RESULTS
A total of 387 oocytes were obtained from the 46 women who participated. Significantly more mature oocytes (M2) were retrieved from normal weight patients compare to obese women (15.1 ± 6.8 vs. 9.7 ± 3.9, respectively, P < 0.001). Oocytes from women in the obese group were significantly smaller than those in the normal weight group, including oocyte diameter (157.9 ± 7.9 vs. 164.3 ± 5.1 μm, P < 0.0001), oolema diameter (110.3 ± 4.5 vs. 113.5 ± 3.5 μm, P < 0.0001), and zona pellucida thickness (17.9 ± 2.6 vs. 19.0 ± 2.4 μm, P < 0.000), respectively. Multivariate logistic regression analysis, including oolema diameter, female age, BMI, number of M2 oocytes, and zona pellucida, was conducted to predict pregnancy. Small oolema diameter in obese patient adversely correlated with pregnancy. Larger oolema diameter was positively associated with the probability of pregnancy in the obese group as well as thinner zona pellucida.
CONCLUSION
Obesity is associated with smaller oocytes, which adversely affect fertility outcomes.
TRIAL REGISTRATION
NIH number NCT01672931.
背景
肥胖与多种生育障碍有关。本前瞻性队列研究旨在评估体重指数（BMI）（kg/m）对卵母细胞直径和治疗的影响。
方法
本研究纳入接受体外受精-胞浆内单精子注射（ICSI）的女性。根据 BMI 将她们分为两组：肥胖（BMI>30）和正常体重（BMI<25）。根据总直径、透明带和卵母细胞外膜直径评估成熟卵母细胞。
结果
46 名女性共获得 387 个卵母细胞。与肥胖女性相比，正常体重女性获得的成熟卵母细胞（M2）明显更多（分别为 15.1±6.8 个和 9.7±3.9 个，P<0.001）。肥胖组的卵母细胞明显小于正常体重组，包括卵母细胞直径（157.9±7.9μm 比 164.3±5.1μm，P<0.0001）、卵母细胞外膜直径（110.3±4.5μm 比 113.5±3.5μm，P<0.0001）和透明带厚度（17.9±2.6μm 比 19.0±2.4μm，P<0.0001）。进行了包括卵母细胞外膜直径、女性年龄、BMI、M2 卵母细胞数量和透明带在内的多变量逻辑回归分析，以预测妊娠。肥胖患者的卵母细胞外膜直径小与妊娠不良相关。肥胖组中较大的卵母细胞外膜直径与妊娠概率呈正相关，而较薄的透明带也是如此。
结论
肥胖与较小的卵母细胞有关，这会对生育结果产生不利影响。
试验注册
NIH 编号 NCT01672931。
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