Zeng Zhonghong, Li Jingjing, Wang Xi, Yi Shanjia, Bi Yin, Mo Dan, Liu Bo, Fu Xiaoqian, Yang Yihua, Ma Wenhong
Guangxi Reproductive Medical Center, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China.
Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases, Nanning, 530021, China.
Heliyon. 2023 Sep 12;9(9):e20095. doi: 10.1016/j.heliyon.2023.e20095. eCollection 2023 Sep.
We previously reported that obese mice had significantly high lipid content in embryos, and excessive lipids are detrimental to embryonic development. However, whether maternal obesity has an effect on embryonic vitrification injury and subsequent pregnancy outcomes is still controversial. This study was conducted to clarify the influence of maternal obesity on embryonic vitrification injury and subsequent pregnancy outcomes by in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).
We retrospectively collected medical record of IVF/ICSI patients from reproductive medicine centers in two tertiary hospitals. The patients were classified into a low-weight group (<18.5 kg/m2), normal-weight group (18.5-23.9 kg/m2), overweight group (24.0-27.9 kg/m2) and obese group (≥28.0 kg/m2) according to their body mass index (BMI). Multivariable logistic regression analysis was performed to compare pregnancy outcomes in fresh and frozen embryo transfer among different BMI groups to define the correlation between BMI and embryonic vitrification injury.
A total of 44 773 women among 20-40 years old were recruited in this study, of which 27 797 underwent their first fresh embryo transfer and 16 976 underwent their first frozen embryo transfer. For fresh embryo transfer, there was no significant difference in the clinical pregnancy rate, live birth rate, and miscarriage rate of 4 BMI groups. For frozen-thawed embryo transfer, there was a significant increase in the clinical pregnancy rate of the overweight group (AOR = 1.14, 95% CI: 1.05-1.25) and the obese group (AOR = 1.24, 95% CI: 1.03-1.50), while the miscarriage rate (AOR = 1.42, 95% CI: 1.05-1.92) also showed a significant increase in the obese group compared to the normal-weight group.
This study provided a new understanding of the effect of maternal obesity on embryonic vitrification injury. Maternal obesity does not worsen the outcome of IVF/ICSI, particularly in the frozen-thawed group.
我们之前报道过肥胖小鼠胚胎中的脂质含量显著偏高，且过多的脂质对胚胎发育有害。然而，母体肥胖是否会对胚胎玻璃化冷冻损伤及随后的妊娠结局产生影响仍存在争议。本研究旨在通过体外受精/卵胞浆内单精子注射（IVF/ICSI）来阐明母体肥胖对胚胎玻璃化冷冻损伤及随后妊娠结局的影响。
我们回顾性收集了两家三级医院生殖医学中心IVF/ICSI患者的病历。根据体重指数（BMI）将患者分为低体重组（<18.5kg/m²）、正常体重组（18.5 - 23.9kg/m²）、超重组（24.0 - 27.9kg/m²）和肥胖组（≥28.0kg/m²）。进行多变量逻辑回归分析，以比较不同BMI组新鲜胚胎移植和冷冻胚胎移植的妊娠结局，从而确定BMI与胚胎玻璃化冷冻损伤之间的相关性。
本研究共纳入44773名20至40岁的女性，其中27797人接受了首次新鲜胚胎移植，16976人接受了首次冷冻胚胎移植。对于新鲜胚胎移植，4个BMI组的临床妊娠率、活产率和流产率无显著差异。对于冻融胚胎移植，超重组（优势比[AOR]=1.14，95%置信区间[CI]：1.05 - 1.25）和肥胖组（AOR = 1.24，95% CI：1.03 - 1.50）的临床妊娠率显著升高，而肥胖组的流产率（AOR = 1.42，95% CI：1.05 - 1.92）与正常体重组相比也显著升高。
本研究为母体肥胖对胚胎玻璃化冷冻损伤的影响提供了新的认识。母体肥胖不会使IVF/ICSI的结局恶化，尤其是在冻融组中。
