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评估冻融胚胎移植后低体重指数患者的体外受精结局。

Evaluating in vitro fertilization outcomes of patients with low body mass index following frozen-thawed embryo transfer.

机构信息

Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, New York, NY, USA.

Reproductive Medicine Associates of New York, New York, NY, USA.

出版信息

Int J Gynaecol Obstet. 2021 Oct;155(1):132-137. doi: 10.1002/ijgo.13570. Epub 2021 Jan 27.

Abstract

OBJECTIVE

To determine the relationship between patients with a low body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) and in vitro fertilization (IVF) outcomes following frozen-thawed embryo transfer (FET).

METHODS

Retrospective cohort study including 12 618 women aged 20-46 years with an underweight (<18.5) or normal weight (18.5-24.9) BMI who underwent controlled ovarian stimulation for IVF in a private and academic IVF center between August 2002 and December 2019.

RESULTS

Anti-Müllerian hormone, peak estradiol levels, number of MII oocytes, and fertilized oocytes were greater in the underweight group compared with the normal weight group. The total required gonadotropin dose was lower in the underweight patients compared with the normal weight patients. MII, fertilization, blastulation, and euploid rates did not differ before and after adjusting for confounders between BMI groups. In a cohort of 316 patients who underwent preimplantation genetic testing for aneuploidy and single euploid FET, pregnancy loss, pregnancy, clinical pregnancy, and live birth rates before and after controlling for covariates were similar between groups.

CONCLUSION

Although there are known fetal growth or obstetrical issues associated in patients with a low BMI, it is reassuring that these risks do not extend to embryologic or clinical outcomes from IVF treatment.

摘要

目的

确定体重指数(BMI;体重以千克为单位除以身高的平方)较低的患者与冻融胚胎移植(FET)后体外受精(IVF)结局之间的关系。

方法

回顾性队列研究包括 12618 名年龄在 20-46 岁之间的女性,她们的 BMI 为消瘦(<18.5)或正常体重(18.5-24.9),在 2002 年 8 月至 2019 年 12 月期间在私人和学术 IVF 中心接受控制性卵巢刺激以进行 IVF。

结果

与正常体重组相比,消瘦组的抗苗勒管激素、峰值雌二醇水平、MII 卵母细胞数和受精卵母细胞数更高。与正常体重患者相比,消瘦患者所需的总促性腺激素剂量更低。在调整 BMI 组之间的混杂因素后,MII、受精、囊胚形成和整倍体率在组间没有差异。在 316 名接受非整倍体植入前遗传检测和单整倍体 FET 的患者队列中,在控制协变量后,妊娠丢失、妊娠、临床妊娠和活产率在组间相似。

结论

尽管体重指数较低的患者存在与胎儿生长或产科问题相关的已知风险,但令人放心的是,这些风险不会扩展到 IVF 治疗的胚胎学或临床结局。

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