Yang Fang, Mao Wei, Ge Yan-Mei, Zhao Xia, Song Jie, Lu Jin-Chun, Liang Yuan-Jiao
Center for Reproductive Medicine, Zhongda Hospital Southeast University Nanjing Jiangsu China.
Wuxi Maternal and Child Health Hospital, Wuxi School of Medicine Jiangnan University Wuxi Jiangsu China.
Health Sci Rep. 2024 Mar 4;7(3):e1947. doi: 10.1002/hsr2.1947. eCollection 2024 Mar.
It is demonstrated that lipid metabolism disorders are associated with the reproductive performances of assisted reproductive technology. However, it is little known whether hyperlipidemia is associated with the endometrial receptivity and pregnancy outcomes of patients undergoing frozen-thawed embryo transfer (FET).
This was a retrospective analysis involving 554 infertile women undergoing FET. The patients were divided into the hyperlipidemia group ( = 224) and control group ( = 320) based on the levels of serum lipids. The clinical and laboratory indexes between the two groups were compared. Meanwhile, the stratified analysis based on body mass index (BMI) and endometrial preparation protocols was performed. The independent samples -test, Mann-Whitney test, 2 test and multiple logistic regression analysis were used to compare and analyze the data.
The patients with hyperlipidemia had significantly higher serum lipids levels and BMI and lower clinical pregnancy and implantation rates than those with normal blood lipids ( < 0.05). The impact of hyperlipidemia on pregnancy outcomes was independent of BMI. The multiple logistic regression analysis showed that higher cholesterol was associated with lower pregnancy rate and implantation rate ( < 0.05). Regardless of blood lipid levels, the patients undergoing the hormone replacement therapy (HRT) protocol had higher estradiol levels and lower progesterone levels compared with the stimulated cycles (STC) ( < 0.05). Moreover, the clinical pregnancy rate and implantation rate of the HRT protocol were higher than those of the STC, although there was no significant difference between the two.
Hyperlipidemia especially higher cholesterol has a negative effect on the pregnancy outcomes of the patients undergoing FET. Actively implementing lipid-lowering treatment and the HRT protocol seem more friendly for these patients.
已证实脂质代谢紊乱与辅助生殖技术的生殖性能相关。然而，高脂血症是否与接受冻融胚胎移植（FET）患者的子宫内膜容受性及妊娠结局相关，目前鲜为人知。
这是一项对554例接受FET的不孕女性进行的回顾性分析。根据血脂水平将患者分为高脂血症组（n = 224）和对照组（n = 320）。比较两组的临床和实验室指标。同时，基于体重指数（BMI）和子宫内膜准备方案进行分层分析。采用独立样本t检验、曼-惠特尼U检验、卡方检验和多元逻辑回归分析对数据进行比较和分析。
高脂血症患者的血脂水平和BMI显著高于血脂正常者，临床妊娠率和着床率则低于血脂正常者（P < 0.05）。高脂血症对妊娠结局的影响独立于BMI。多元逻辑回归分析显示，较高的胆固醇水平与较低的妊娠率和着床率相关（P < 0.05）。无论血脂水平如何，接受激素替代疗法（HRT）方案的患者与刺激周期（STC）相比，雌二醇水平较高，孕酮水平较低（P < 0.05）。此外，HRT方案的临床妊娠率和着床率高于STC，尽管两者之间无显著差异。
高脂血症尤其是较高的胆固醇水平对接受FET患者的妊娠结局有负面影响。积极实施降脂治疗和HRT方案对这些患者似乎更为有利。
