Obstetrics and Gynecology Department, Kasr Al Aini Hospital, Cairo University, Cairo, Egypt.
Department of Gynecology and Obstetrics, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt.
Int J Gynaecol Obstet. 2019 Feb;144(2):161-166. doi: 10.1002/ijgo.12706. Epub 2018 Nov 26.
To assess the effects of body mass index (BMI) on the outcome of IVF cycles among poor responders.
A prospective cohort study in Egypt enrolled 185 poor responders who underwent intracytoplasmic sperm injection via an antagonist protocol between 2012 and 2017. Participants were classified into three groups by BMI (calculated as weight in kilograms divided by the square of height in meters): 18.5-24.9 (normal, n=48); 25-29.9 (overweight, n=54); 30 or higher (obese, n=83). Outcomes were clinical pregnancy rate, implantation rate, chemical pregnancy rate, gonadotropin dose, number of oocytes and embryos, and cancellation rate.
There was no significant difference among the three groups in gonadotropin dose; duration of stimulation; endometrial thickness on trigger day; number of oocytes retrieved, injected, or fertilized; number of embryos, transferred embryos, or frozen embryos; or day of embryo transfer. Frequency of implantation (11/81 [14%] vs 6/96 [6%] or 5/155 [3%]), chemical pregnancy (20 [42%] vs 14 [30%] or 12 [14%]) and clinical pregnancy (15 [31%] vs 12 [22%] and 9 [11%]) was significantly higher for normal than for overweight or obese women, respectively.
Implantation, chemical pregnancy, and clinical pregnancy rates were inversely related to increasing BMI. CLINICALTRIALS.GOV: NCT03457233.
评估体重指数（BMI）对卵巢反应不良患者体外受精（IVF）周期结局的影响。
这是一项在埃及进行的前瞻性队列研究，共纳入了 185 名卵巢反应不良患者，他们于 2012 年至 2017 年期间接受了拮抗剂方案的卵胞浆内单精子注射。根据 BMI（体重以千克为单位除以身高的平方）将参与者分为三组：18.5-24.9（正常，n=48）；25-29.9（超重，n=54）；30 或更高（肥胖，n=83）。观察指标包括临床妊娠率、着床率、生化妊娠率、促性腺激素剂量、获卵数和胚胎数，以及取消率。
三组间促性腺激素剂量、刺激持续时间、扳机日子宫内膜厚度、获卵数、注射卵数或受精卵数、胚胎数、移植胚胎数或冷冻胚胎数或胚胎移植日均无显著差异。正常组的着床率（11/81[14%]比 6/96[6%]或 5/155[3%]）、生化妊娠率（20[42%]比 14[30%]或 12[14%]）和临床妊娠率（15[31%]比 12[22%]和 9[11%]）均显著高于超重或肥胖组。
随着 BMI 的增加，着床率、生化妊娠率和临床妊娠率呈下降趋势。临床试验.gov：NCT03457233。
