Laboratory of Assisted Reproduction. Alcívar Hospital, Guayaquil, Ecuador.
JBRA Assist Reprod. 2021 Jul 21;25(3):394-402. doi: 10.5935/1518-0557.20200105.
The objective of this study was to evaluate the effects of overweight and obesity on fertility outcomes in IVF procedures.
This was a retrospective and nonrandomized study that included 191 IVF/ICSI cycles using non-donor oocytes performed between July 2016 and December 2018 that were allocated according to Body Mass Index (BMI) in three groups: Normal group: 18.5-24.9 (n=67 women), Overweight group: 25.0-29.9 (n=86 women) and Obesity group: ≥30.0 (n=38 women). We compared fertilization rates, embryo quality at day 3, development and quality of blastocyst, pregnancy rates, implantation rates, and live birth rates.
Patients from all groups had similar stimulation days, but those women with overweight and obesity used more hormones compared to women with normal weight (p<0.05). Fertilization rates, zygotes that underwent cleavage and good-quality embryos at Day 3 were similar between the three evaluated groups. The groups of overweight and obesity had embryos at Day 3 with significantly less cells, compared to those from the normal group (p<0.05). The blastocyst development rate was significantly lower in women with overweight and obesity compared to women with normal BMI (p<0.05); but, the percentages of good blastocysts were similar in all studied patients. Pregnancy, implantation and live birth rates were significantly lower in the group of women with overweight and obesity, compared to those women with normal weight (p<0.05). Obese women had significantly more miscarriages compared to those in the other groups (p<0.05).
Our data shows that an increased BMI affects embryo development and significantly reduces the pregnancy, implantation and live birth rates.
本研究旨在评估超重和肥胖对体外受精（IVF）程序中生育结局的影响。
这是一项回顾性非随机研究，纳入了 2016 年 7 月至 2018 年 12 月期间使用非捐赠卵子进行的 191 个 IVF/ICSI 周期，根据体重指数（BMI）将这些周期分为三组：正常组：18.5-24.9（n=67 名女性），超重组：25.0-29.9（n=86 名女性）和肥胖组：≥30.0（n=38 名女性）。我们比较了受精率、第 3 天胚胎质量、胚胎发育和囊胚质量、妊娠率、种植率和活产率。
所有组别的患者的促排卵天数相似，但超重和肥胖患者的激素用量多于体重正常的患者（p<0.05）。三组患者的受精率、卵裂胚胎数和第 3 天的优质胚胎数相似。与正常体重组相比，超重和肥胖组的第 3 天胚胎细胞数明显较少（p<0.05）。超重和肥胖组的囊胚发育率明显低于正常 BMI 组（p<0.05）；但是，所有研究患者的优质囊胚百分比相似。与体重正常的患者相比，超重和肥胖组的妊娠、种植和活产率明显较低（p<0.05）。肥胖患者的流产率明显高于其他两组（p<0.05）。
我们的数据表明，BMI 的增加会影响胚胎发育，显著降低妊娠、种植和活产率。
