Influence of body mass index on clinical outcome of in vitro fertilization-embryo transfer in patients with polycystic ovary syndrome
10.3760/cma.j.cn101441-20200726-00415
- VernacularTitle:体质量指数对多囊卵巢综合征患者体外受精-胚胎移植临床结局的影响
- Author:
Haixia JIN
1
;
Yuanyuan LIU
1
;
Fuli ZHANG
1
;
Lei CHEN
1
;
Lin QI
1
;
Xiaopeng WANG
1
Author Information
1. 郑州大学第一附属医院生殖医学中心，河南省生殖与遗传重点实验室，郑州 450052
- Publication Type:Journal Article
- Keywords:
Polycystic ovary syndrome;
Body mass index;
Fertilization in vitro;
Embryo transfer;
Pregnancy outcome;
Neonatal outcome
- From:
Chinese Journal of Reproduction and Contraception
2022;42(3):253-260
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the outcome of in vitro fertilization-embryo transfer (IVF-ET) in patients with polycystic ovary syndrome (PCOS) under different body mass index (BMI). Methods:A retrospective cohort study was performed on the clinical data of 2982 patients under 35 years old who received the first cycle with adopted long-term follicular phase plan during January 2016 to December 2018 in the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University, including 999 patients with PCOS (PCOS group) and 1983 patients with infertility due to tubal factors alone without other complications (non-PCOS group). Patients in PCOS group were divided into overweight PCOS group (24.0 kg/m 2≤BMI<28.0 kg/m 2) and normal weight PCOS group (18.5 kg/m 2≤BMI<24.0 kg/m 2). The general information, pregnancy outcome and embryo development indexes of patients in each group were calculated and compared, and the effects of BMI on pregnancy outcome and embryo development potential were analyzed. Meanwhile, the correlation between newborn birth weight and maternal BMI was studied. Results:High-quality embryo rate [67.41% (1906/2826)], blastocyst formation rate [56.39% (578/1025)], high-quality blastocyst formation rate [29.75% (305/1025)] and available embryo rate [62.14% (1756/2826)] of normal weight PCOS group were all higher than those of overweight PCOS group [62.65% (1753/2798), P<0.001; 47.30% (457/966), P<0.001; 16.35% (158/966), P<0.001; 59.04% (1652/2798), P=0.018]. Normal weight PCOS group compared with overweight PCOS group transferred on day 5 (D5), total fertilization rate [82.38% (1711/2077)], two pronuclei (2PN) fertilization rate [68.03% (1413/2077)], blastocyst formation rate, high-quality blastocyst formation rate [68.90% (554/804)], and available embryo rate [57.16% (802/1403)] were higher in normal weight PCOS group [80.21% (2954/3683), P=0.044; 64.76% (2385/3683), P=0.012; 63.95% (871/1362), P<0.001; 30.32% (413/1362), P<0.001; 53.03% (1250/2357), P=0.014]. The implantation rate [66.67% (72/108)], the clinical pregnancy rate [66.97% (73/109)] and the miscarriage rate [9.59% (7/73)] in normal weight PCOS group transferred on D5, were higher than those in the overweight PCOS group [80.57% (141/175), P=0.008; 80.46% (140/174), P=0.011; 20.71% (29/140), P=0.040]. The odds of clinical pregnancy rate (a OR=1.92, 95% CI=1.049-3.515, P=0.034) and miscarriage rate (a OR=3.09, 95% CI=1.209-7.915, P=0.019) were increased in the overweight PCOS group transferred on D5. Pearson correlation analysis showed that BMI of D3 and D5 transplanted PCOS patients and D3 transplanted non-PCOS patients were positively correlated with neonatal birth weight ( r=0.144, P=0.013; r=0.212, P=0.004; r=0.137, P<0.001), the difference was statistically significant. The odds of macrosomia (a OR=5.33, 95% CI=1.525-18.597, P=0.009) were increased in the overweight PCOS group transferred on D5. Conclusion:The increase of BMI may be the main factor affecting embryo quality and leading to higher abortion rate in PCOS patients. Being overweight or obese may lead to an increase in birth weight and weight loss in PCOS patients before IVF-ET will improve embryo quality and control newborn birth weight.
