Chaves Hanne Lise, Schmitz Mateus José, Francisquini Camila Dutra de Souza, Rosa Vinicius Bonato da, Schuffner Alessandro, Furlan Janaina de Almeida
Positivo University - Curitiba, Paraná, Brazil.
Conceber Clinic - Reproductive Medicine Center, Curitiba, Paraná, Brazil.
JBRA Assist Reprod. 2023 Aug 14;27(4):594-601. doi: 10.5935/1518-0557.20230041.
To evaluate the impact of body mass index associated with advanced maternal age on pregnancy outcomes.
A retrospective and observational study that included 808 in vitro fertilization cycles and evaluated: age, weight, height, number of oocytes and mature oocytes, number of embryos and transferred embryos, fertilization and clinical pregnancy rates. Four categories of body mass index: underweight, adequate weight, overweight and obesity. We classified age into 4 categories: 35-37; 38-40; 41-42 and over 42 years of age. The means and rates were calculated and compared between different ages and body mass index groups.
For the fresh group, women who achieved clinical pregnancy had a lower mean age than those who did not become pregnant, being the higher the pregnancy rate the lower the age (p<0.0001). After logistic regression analysis for data associated with clinical pregnancy in the fresh group, the number of transferred embryos remained higher in the overweight category (p=0.0001). Overweight and obese women had a significantly higher rate of mature oocytes when compared with adequate weight (p=0.015). Analysis using the ROC curve indicated an area under the curve of 60% (p=0.002) for the fresh group.
The adverse effect of high BMI on clinical pregnancy rates is greater in women under 35 years compared to older women; and age had a higher impact on live birth rate rather than BMI, when the analysis was performed on older women, with the impact of BMI on the probability of having a live birth depending on maternal age.
评估与高龄产妇相关的体重指数对妊娠结局的影响。
一项回顾性观察研究，纳入808个体外受精周期，并评估：年龄、体重、身高、卵母细胞和成熟卵母细胞数量、胚胎数量和移植胚胎数量、受精率和临床妊娠率。体重指数分为四类：体重过轻、体重正常、超重和肥胖。我们将年龄分为四类：35 - 37岁；38 - 40岁；41 - 42岁和42岁以上。计算并比较不同年龄和体重指数组之间的均值和比率。
对于新鲜胚胎组，实现临床妊娠的女性平均年龄低于未妊娠女性，妊娠率越高年龄越低（p<0.0001）。对新鲜胚胎组与临床妊娠相关的数据进行逻辑回归分析后，超重类别中移植胚胎数量仍然较高（p = 0.0001）。与体重正常的女性相比，超重和肥胖女性的成熟卵母细胞率显著更高（p = 0.015）。使用ROC曲线分析表明，新鲜胚胎组曲线下面积为60%（p = 0.002）。
与年龄较大的女性相比，高体重指数对35岁以下女性临床妊娠率的不利影响更大；对年龄较大的女性进行分析时，年龄对活产率的影响大于体重指数，体重指数对活产概率的影响取决于产妇年龄。
