Ni Danyu, Wei Yi, Xie Qijun, Wang Xinyu, Yu Kaidi, Jiang Wei, Yang Ye, Ling Xiufeng
Department of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, China.
Front Endocrinol (Lausanne). 2025 Jan 10;15:1474201. doi: 10.3389/fendo.2024.1474201. eCollection 2024.
The increasing prevalence of obesity underscores the need to explore its impact on assisted reproductive technology (ART) outcomes. This study aims to evaluate the association between visceral fat area (VFA), measured by bioelectrical impedance analysis (BIA), and pregnancy outcomes following frozen embryo transfer (FET).
In this retrospective clinical study, the data of 1,510 patients who underwent FET between April 2022 and April 2023 were analyzed. The VFA was measured by BIA, and patients were categorized into low and high VFA groups based on a threshold of 65 cm². Pregnancy outcomes were compared between the two groups. Univariable and multivariate logistic regression analyses, along with restricted cubic spline (RCS) modeling, were used to adjust for age, body mass index (BMI), and basal estradiol (E2) levels to determine the relationship between VFA and FET outcomes.
There were significant differences in baseline characteristics and outcomes between the two groups. The high VFA group was characterized by older age and a lower basal estradiol (E2) level. The biochemical pregnancy rate, implantation rate, clinical pregnancy rate (CPR), and live birth rate (LBR) were significantly lower in the high VFA group. Logistic regression revealed a significant negative correlation between the high VFA group and both CPR and LBR. The RCS model demonstrated that the VFA was nonlinearly correlated with CPR and LBR. Subgroup analysis showed that among individuals under 35 years of age or with a BMI < 24, high VFA was significantly associated with poorer CPR and LBR.
High VFA is associated with poorer pregnancy outcomes after FET in female patients with infertility, with both CPR and LBR decreasing as VFA increases. Clinicians should consider VFA as an important reference for targeted fat management interventions to optimize reproductive success, especially when VFA exceeds 65 cm².
肥胖患病率的不断上升凸显了探索其对辅助生殖技术（ART）结局影响的必要性。本研究旨在评估通过生物电阻抗分析（BIA）测量的内脏脂肪面积（VFA）与冻融胚胎移植（FET）后妊娠结局之间的关联。
在这项回顾性临床研究中，分析了2022年4月至2023年4月期间接受FET的1510例患者的数据。通过BIA测量VFA，并根据65 cm²的阈值将患者分为低VFA组和高VFA组。比较两组的妊娠结局。采用单变量和多变量逻辑回归分析以及受限立方样条（RCS）建模，对年龄、体重指数（BMI）和基础雌二醇（E2）水平进行调整，以确定VFA与FET结局之间的关系。
两组之间的基线特征和结局存在显著差异。高VFA组的特点是年龄较大且基础雌二醇（E2）水平较低。高VFA组的生化妊娠率、着床率、临床妊娠率（CPR）和活产率（LBR）显著较低。逻辑回归显示高VFA组与CPR和LBR均呈显著负相关。RCS模型表明VFA与CPR和LBR呈非线性相关。亚组分析显示，在35岁以下或BMI<24的个体中，高VFA与较差的CPR和LBR显著相关。
高VFA与不孕女性患者FET后的妊娠结局较差相关，CPR和LBR均随VFA增加而降低。临床医生应将VFA视为针对性脂肪管理干预措施的重要参考指标，以优化生殖成功率，尤其是当VFA超过65 cm²时。
