Department of Obstetrics, Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore's Institute for Reproductive Medicine and Health, Hartsdale, New York.
Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Medical Center, New York, New York.
Fertil Steril. 2024 Feb;121(2):291-298. doi: 10.1016/j.fertnstert.2023.11.005. Epub 2023 Nov 10.
To determine whether body mass index (BMI) was associated with live birth in patients undergoing transfer of frozen-thawed preimplantation genetic testing for aneuploidy (PGT-A) embryos.
Retrospective cohort study of cycles reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System.
All autologous and donor recipient PGT-A-tested cycles reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System from 2014 to 2017.
INTERVENTION(S): Body mass index.
MAIN OUTCOME MEASURE(S): The primary outcome measure was the live birth rate, and the secondary outcome measures were the clinical pregnancy and biochemical pregnancy rates. Multivariable generalized additive mixed models and log-binomial models were used to model the relationship between BMI and outcome measures.
RESULT(S): A total of 77,018 PGT-A cycles from 55,888 patients were analyzed. Of these cycles, 70,752 were autologous, and 6,266 were donor recipient. In autologous cycles, a statistically significant and clear nonlinear relationship was observed between the BMI and live birth rates, with the highest birth rates observed for the BMI range of 23-24.99 kg/m. When using 23-24.99 kg/m as the referent, other BMI ranges demonstrated a lower probability of live birth and clinical pregnancy that continued to decrease as the BMI moved further from the reference value. Patients with a BMI of <18.5 kg/m had a 11% lower probability of live birth, whereas those with a BMI of ≥40 kg/m had a 27% lower probability than the referent.
CONCLUSION(S): A normal-weight BMI range of 23-24.99 kg/m was associated with the highest probability of clinical pregnancy and live birth after a frozen-thawed PGT-A-tested blastocyst transfer in both autologous and donor recipient cycles. A BMI outside the range of 23-24.99 kg/m is likely associated with a malfunction in the implantation process, which is presumed to be related to a uterine factor and not an oocyte factor, as both autologous and donor recipient cycle outcomes were associated similarly with the BMI of the intended parent.
确定体质量指数（BMI）是否与接受冷冻解冻胚胎植入前遗传学检测（PGT-A）胚胎移植的患者的活产有关。
向辅助生殖技术协会临床结果报告系统报告的周期的回顾性队列研究。
向辅助生殖技术协会临床结果报告系统报告的 2014 年至 2017 年期间的所有自体和供体受体 PGT-A 检测周期。
体质量指数。
主要观察指标为活产率，次要观察指标为临床妊娠率和生化妊娠率。多变量广义加性混合模型和对数二项式模型用于模拟 BMI 与结局指标之间的关系。
共分析了 77018 个 PGT-A 周期，涉及 55888 名患者。这些周期中，70752 个为自体周期，6266 个为供体受体周期。在自体周期中，观察到 BMI 与活产率之间存在显著且明确的非线性关系，BMI 范围在 23-24.99 kg/m 时活产率最高。当以 23-24.99 kg/m 为参照时，其他 BMI 范围活产和临床妊娠的概率较低，并且随着 BMI 与参考值的距离越来越远，这种概率持续下降。BMI＜18.5 kg/m 的患者活产的概率降低 11%，而 BMI≥40 kg/m 的患者活产的概率比参照值降低 27%。
在接受冷冻解冻 PGT-A 检测的囊胚移植后，自体和供体受体周期中，正常体重 BMI 范围 23-24.99 kg/m 与临床妊娠和活产的概率最高。BMI 超出 23-24.99 kg/m 范围可能与着床过程中的功能障碍有关，这被认为与子宫因素有关，而不是卵母细胞因素有关，因为自体和供体受体周期的结局都与预期父母的 BMI 相关。
