Setti Amanda Souza, Halpern Gabriela, Braga Daniela Paes de Almeida Ferreira, Iaconelli Assumpto, Borges Edson
Fertility Medical Group, Av. Brigadeiro Luis Antonio, 4545, São Paulo - SP 01401-002, Brazil; Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, Rua Vieira Maciel, 62, São Paulo - SP 04503-040, Brazil.
Fertility Medical Group, Av. Brigadeiro Luis Antonio, 4545, São Paulo - SP 01401-002, Brazil.
Reprod Biomed Online. 2022 Feb;44(2):370-379. doi: 10.1016/j.rbmo.2021.08.025. Epub 2021 Sep 3.
Do maternal lifestyle factors influence the incidence of oocyte dimorphisms and outcomes of intracytoplasmic sperm injection (ICSI) cycles?
A total of 752 female patients undergoing an ICSI cycle at a private university-affiliated IVF centre from January 2015 to December 2019 were included in this historical cohort study. Before starting ovarian stimulation, participants completed a questionnaire on cigarette smoking habits, consumption of alcoholic beverages, refined sugar, artificial sweeteners, soft drinks, fruits, legumes and vegetables, milk and dairy, and meat, as well as exercise frequency over the past 6 months. Oocyte morphology was evaluated before ICSI. The influence of maternal lifestyle factors on the incidence of oocyte dimorphisms and ICSI outcomes was evaluated by multivariate general linear models and generalized linear models, adjusted for potential confounders. The main outcome measures were the incidence of oocyte dimorphisms per cycle and clinical outcomes.
Lifestyle factors and nutritional habits such as cigarette smoking, and the consumption of alcohol, refined sugar and artificial sweeteners, were positively associated with incidence of several oocyte dimorphisms and negatively associated with the response to ovarian stimulation and embryo development. Negative relationships were also observed between these habits and clinical outcomes, apart from miscarriage rate, in which positive relationships were observed. Significant negative dose-dependent relationships between these habits and implantation rates were noted (P < 0.001). Alcoholic beverage consumption also showed inverse dose-dependent relationships with clinical pregnancy and live birth rates. Live birth rate was also negatively associated with cigarette smoking, in a dose-dependent manner.
Poor maternal habits were associated with reduced oocyte quality and ICSI outcomes in this study. Many of these associations were shown to be dose-dependent.
母亲的生活方式因素是否会影响卵母细胞二态性的发生率及卵胞浆内单精子注射（ICSI）周期的结局？
本历史队列研究纳入了2015年1月至2019年12月期间在一所私立大学附属体外受精中心接受ICSI周期治疗的752名女性患者。在开始卵巢刺激之前，参与者完成了一份关于吸烟习惯、酒精饮料、精制糖、人工甜味剂、软饮料、水果、豆类和蔬菜、牛奶及奶制品以及肉类的消费情况的问卷，以及过去6个月的运动频率。在ICSI前评估卵母细胞形态。通过多变量一般线性模型和广义线性模型评估母亲生活方式因素对卵母细胞二态性发生率和ICSI结局的影响，并对潜在混杂因素进行校正。主要结局指标为每个周期卵母细胞二态性发生率和临床结局。
吸烟、酒精饮料、精制糖和人工甜味剂等生活方式因素和营养习惯与几种卵母细胞二态性的发生率呈正相关，并与卵巢刺激反应及胚胎发育呈负相关。除流产率呈正相关外（观察到这些习惯与流产率呈正相关关系），在这些习惯与其他临床结局之间也观察到负相关关系。注意到这些习惯与着床率之间存在显著的负剂量依赖性关系（P < 0.001）。酒精饮料消费与临床妊娠率和活产率也呈反向剂量依赖性关系（酒精饮料消费与临床妊娠率和活产率也呈现出反向剂量依赖性关系）。活产率也与吸烟呈负相关，且呈剂量依赖性。
在本研究中，母亲的不良习惯与卵母细胞质量降低及ICSI结局不良有关。其中许多关联显示为剂量依赖性。
