IVI-RMA Valencia, Plaza de la Policía Local, 3, 46015, Valencia, Spain.
Department of Pediatrics, Obstetrics & Gynecology, University of Valencia, Valencia, Spain.
Reprod Sci. 2021 Nov;28(11):3171-3180. doi: 10.1007/s43032-021-00631-1. Epub 2021 May 25.
Our aim was to determine prospectively whether increased body mass index (BMI) affects endometrial receptivity through displacement of the window of implantation (dWOI) using the endometrial receptivity analysis (ERA), and whether this effect is BMI-dependent. We recruited a population of 170 infertile women with a normal uterus and no clinical history of recurrent miscarriage or implantation failure. These women were divided into four groups according to BMI: normal weight (18.5-24.9 kg/m; n = 44), overweight (25-29.9 kg/m; n = 29), class I obese (30.0-34.9 kg/m; n = 54), and class II and III obese (> 35 kg/m; n = 43). We also assigned the patients to one of two larger BMI cohorts: non-obese (normal weight and overweight; n = 73) and obese (class I, II, and III obese; n = 97). We compared analytical and clinical data and dWOI in these categories, finding significant metabolic differences in glycemia, TSH, insulin, HDL cholesterol, LDL cholesterol, triglycerides, and systolic and diastolic blood pressure among the different BMI groups. One-day dWOI increased significantly with BMI, and significant differences were observed in the non-obese versus obese categories (9.7% vs 25.3 %, respectively (p = 0.02)). dWOI was most pronounced in patients with class II-III obesity. In addition, displacement was longer as BMI increased since ERA revealed a higher proportion of displacements of 1 day than of 12 h and showed they were predominantly pre-receptive. In conclusion, obesity has a negative effect on endometrial receptivity through delaying of the WOI, which increases in function of BMI as well as the metabolic disturbances of the patient.
我们的目的是通过子宫内膜容受性分析（ERA）来确定体重指数（BMI）的增加是否通过改变种植窗（dWOI）来影响子宫内膜容受性，以及这种影响是否依赖于 BMI。我们招募了 170 名具有正常子宫且无反复流产或着床失败临床病史的不孕妇女作为研究对象。这些女性根据 BMI 分为四组：正常体重（18.5-24.9kg/m²；n=44）、超重（25-29.9kg/m²；n=29）、I 度肥胖（30.0-34.9kg/m²；n=54）和 II 度和 III 度肥胖（>35kg/m²；n=43）。我们还将患者分为两组较大的 BMI 队列：非肥胖（正常体重和超重；n=73）和肥胖（I 度、II 度和 III 度肥胖；n=97）。我们比较了这些类别的分析和临床数据以及 dWOI，发现不同 BMI 组之间的血糖、TSH、胰岛素、HDL 胆固醇、LDL 胆固醇、甘油三酯以及收缩压和舒张压存在显著的代谢差异。dWOI 随着 BMI 的增加而显著增加，非肥胖组与肥胖组之间存在显著差异（分别为 9.7%和 25.3%（p=0.02））。在 II 度-III 度肥胖患者中，dWOI 的变化最为明显。此外，随着 BMI 的增加，位移也会变长，因为 ERA 显示出 1 天的位移比例高于 12 小时，并且它们主要是前接受性的。总之，肥胖通过延迟 WOI 对子宫内膜容受性产生负面影响，而 WOI 的延迟程度与 BMI 以及患者的代谢紊乱程度成正比。
