Relationship of low body mass index and embryo transfer number to pregnancy outcome of women undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer
10.3760/cma.j.cn101441-20190603-00242
- VernacularTitle:女性低体质量指数和移植胚胎数与体外受精/卵胞质内单精子显微注射-胚胎移植妊娠结局的相关性
- Author:
Dingfei XU
1
;
Qiongfang WU
1
;
Leizhen XIA
1
Author Information
1. 江西省妇幼保健院辅助生殖中心，南昌 330006
- Publication Type:Journal Article
- Keywords:
Body mass index;
Fertilization in vitro;
Intracytoplasmic sperm injection;
Embryo transfer;
Pregnancy outcomes
- From:
Chinese Journal of Reproduction and Contraception
2020;40(6):476-480
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship of low body mass index (BMI) and embryo transfer number to pregnancy outcome of in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) in women. Methods:Totally 9630 cases of women undergoing IVF/ICSI-ET treatment in the Assisted Reproductive Center of Jiangxi Provincial Maternal and Child Hospital from January 2014 to October 2017 were retrospectively analyzed. They were divided into two groups according to BMI， group A: the low BMI group (BMI<18.5 kg/m 2, 2333 cases); group B: the normal BMI group (BMI=18.5-23.9 kg/m 2, 7297 cases). Group A was further divided into subgroup A1 and subgroup A2 according to the number of transplanted embryos, subgroup A1: selected transfer one embryo [including selective transfer of 1 day 3 (D3) embryo or 1 blastocyst], 414 cases; subgroup A2: transfer two embryos, 1919 cases. Two embryos were transfered in group B. The pregnancy outcomes were compared between subgroup A2 and group B and those of subgroup A1 and subgroup A2. Results:1) Comparison of subgroup A2 and group B: there was no significant difference of pregnancy complications between these two groups, such as hypertension, premature rupture of membranes, diabetes, and eclampsia ( P>0.05). The clinical pregnancy rate (64.77%) and the implantation rate (46.43%) in subgroup A2 were lower than those in group B (68.73%, 49.39%), the differences were statistically significant ( P=0.002, P=0.001). There was no significant difference in the multiple pregnancy rate between the two groups （ P>0.05）. Subgroup A2 had a higher rate of preterm birth (24.56%), while the live birth rate (55.81%) and newborn birth weight [(2 773.7±631.0) g] were lower than those in group B [21.47%， 58.65%， (2 825.2±628.1) g], the differences were statistically significant ( P=0.030， P=0.022， P=0.002). There was no significant difference between the two groups in the gestational age of delivery and the ratio of twin reduction ( P>0.05). 2) Comparison of subgroup A1 and subgroup A2: in subgroup A1 the age [(29.80±4.87) years], the clinical pregnancy rate (55.31%), the multiple pregnancy rate (2.62%), the live birth rate (45.17%), the premature delivery rate (6.95%), the rate of hypertensive syndrome in pregnancy (0.40%) were lower than those in subgroup A2 [(30.43±5.05) years， P=0.014； 64.77%， P<0.001； 4.81%， P<0.001； 55.81%， P<0.001； 24.56%， P<0.001； 2.74%， P=0.036]， the differences were statistically significant. The implantation rate (55.31%) was higher than that in subgroup A2 (46.43%), and the difference was statistically significant ( P<0.001). There was no significant difference in the early abortion rate between the two groups ( P>0.05). However, the total miscarriage rate (16.59%) was higher and the gestational week [(38.35±1.51) weeks] was larger in subgroup A1, and the differences between subgroup A1 and subgroup A2 [11.02%, (37.52±2.31) weeks] were statistically significant ( P=0.015, P<0.001). 3) Comparison of twin birth outcomes between group A and group B: the birth weight of group A was lower [(2 379.7±478.6) g], and the proportion of low birth weight (61.79%) was higher than that in group B [(2 473.7±490.1) g， 52.04%], the differences were statistically significant ( P<0.001, P<0.001), while the proportion of very low birth weight was not statistically significant between the two groups ( P>0.05). Conclusion:Selective transplantation of one embryo in patients with low BMI can significantly reduce the incidence of preeclampsia, preterm delivery and multiple pregnancies, and increase the birth weight of newborns. It is conducive to the protection of maternal and child safety at the source and the improvement of newborn outcomes.
