Effect of body mass index and body weight on ovarian response in in vitro fertilization-embryo transfer with early follicular phase long-acting long regimen
10.3760/cma.j.cn101441-20210322-00140
- VernacularTitle:体质量指数与体质量对早卵泡期长效长方案治疗后卵巢反应性的影响
- Author:
Leizhen XIA
1
;
Lifeng TIAN
1
;
Qiongfang WU
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;
Body weight;
Ovarian response;
Early follicular phase long-acting long regimen
- From:
Chinese Journal of Reproduction and Contraception
2022;42(9):887-893
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of body mass index (BMI) and body weight on the ovarian responsiveness of patients undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) treatment with early follicular phase long-acting long regimen, and to instruct reproductive doctors to choose the most accurate indicators when formulating individualized starting dosage of gonadotropin (Gn). Methods:A retrospective cohort study analysis of the clinical data of 5762 patients who applied the early follicular phase long-acting long regimen and the Gn starting dosage was 112.5 U during IVF/ICSI-ET treatment at the Assisted Reproductive Center of Jiangxi Maternal and Child Health Hospital from January 2014 to December 2019. Totally 1/5 patients in the middle of BMI (BMI range: 20.70-22.03 kg/m 2) were selected and divided into low weight group (<51 kg), normal weight group (51-56 kg), and high weight group (>56 kg). According to body weight, the ovarian reactivity was analyzed among the three groups. In the same way, 1/5 patients in the middle of weight (weight range: 52 kg to 55 kg) were divided into low BMI group (<20.30 kg/m 2), normal BMI group (20.30-22.19 kg/m 2), high BMI group (>22.19 kg/m 2) and the ovarian reactivity of the three groups was analyzed. Results:There were significant differences in total Gn used dosage [1 612.50(1 350.00, 1 950.00) U vs. 1 687.50(1 387.50, 2 100.00) U vs. 1 793.75(1 443.75, 2 250.00) U], progesterone level [0.89(0.60, 1.19) μg/L vs. 0.78(0.53, 1.05) μg/L vs. 0.69(0.50, 0.92) μg/L] and estradiol level [2 569.00(1 774.00, 3 681.00) ng/L vs. 2 208.50(1 614.00, 3 020.52) ng/L vs. 2 018.00(1 385.00, 2 787.00) ng/L] on the day of human chorionic gonadotropin (hCG) injection, IVF normal fertilization rate [66.36% (1539/2319) vs. 66.46% (5460/8216) vs. 62.86% (1281/2038)] and ICSI normal fertilization rate [74.77% (320/428) vs. 78.31% (1368/1747) vs. 71.34% (224/314)] among the 1/5 patients in the middle of BMI grouped by body weight ( P=0.006, P<0.001, P<0.001, P=0.008, P=0.014). Covariance analysis was used to balance BMI, age and antral follicle count (AFC), and it is found that the number of oocytes retrieved in the three groups was significantly different ( P=0.022). However, for the 1/5 patients in the middle of body weight grouped by BMI, there were significant differences in age [28(26, 31) years vs. 29(27, 32) years vs. 29(27, 32) years], total Gn used dosage [1 725.00(1 368.75,2 100.00) U vs. 1 725.00(1 387.50, 2 100.00) U vs. 1 875.00(1 425.00,2 300.00) U], IVF normal fertilization rate [66.06% (1775/2687) vs. 65.88% (5689/8635) vs. 62.91% (1589/2526)], ICSI normal fertilization rate [74.73% (482/645) vs. 77.93% (1511/1939) vs. 67.97% (418/615)] and the number of available embryos [3.0(2.0,5.0) vs. 3.0(2.0,5.0) vs. 3.0(2.0,4.0)] among the three groups ( P=0.015, P=0.042, P=0.015, P<0.001, P<0.001). The results of covariance analysis showed that there was no difference in the number of oocytes retrieved among the three groups after balancing BMI, age and AFC ( P=0.443). Conclusion:Body weight is more predictive of ovarian responsiveness than BMI. It is recommended that reproductive doctors determine the starting dosage of Gn based on body weight rather than BMI.
