Effects of body fat percent on outcome of IVF/ICSI in infertile women
10.3760/cma.j.cn101441-20240604-00207
- VernacularTitle:体脂率对不孕症女性IVF/ICSI妊娠结局的影响
- Author:
Wenjing LI
1
;
Yichun GUAN
1
;
Shuang YU
1
;
Zhuolun SU
1
;
Ninghua XU
1
;
Hua LOU
1
Author Information
1. 郑州大学第三附属医院生殖健康医院，郑州 450052
- Publication Type:Journal Article
- Keywords:
Embryo transfer;
Infertility;
Body fat percent;
Outcomes of assisted pregnancy
- From:
Chinese Journal of Reproduction and Contraception
2024;44(12):1250-1257
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of body fat percent (BFP) on assisted reproductive outcomes in infertile women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) and fresh embryo transfer. Methods:We analyzed clinical data on infertile women in a retrospective cohort study, who underwent IVF/ICSI and embryo transfer at the Reproductive Health Hospital of the Third Affiliated Hospital of Zhengzhou University from March 2022 to October 2023. The study subjects were divided into non-obese group (BFP<35%, 800 cases) and obese group (BFP≥35%, 742 cases) according to BFP. The baseline data, ovulation induction outcomes and clinical pregnancy outcomes were compared between the two groups.Results:1) The body mass index [BMI, 25.85 (24.22, 28.04) kg/m 2], basal testosterone [0.80 (0.45, 1.12) nmol/L], triglyceride [1.29 (1.03, 1.59) mmol/L], serum total cholesterol [4.55 (4.29, 4.81) mmol/L], low-density lipoprotein cholesterol [3.17 (2.90, 3.40) mmol/L], fasting glucose [5.40 (5.10, 5.75) mmol/L], fasting insulin [12.99 (9.01, 18.31) mU/L], homeostasis model assessment-insulin resistance [3.09 (2.14, 4.50)], antral follicle count [16.00 (11.00, 22.00)], the patients combined with polycystic ovary syndrome [9.4% (70/742)] in obese group were significantly higher than those in non-obese group [21.94 (20.32, 23.51) kg/m 2, P<0.001; 0.69 (0.43, 0.98) nmol/L, P<0.001; 1.00 (0.79, 1.21) mmol/L, P<0.001; 4.42 (4.19, 4.66) mmol/L, P<0.001; 2.91 (2.67, 3.15) mmol/L, P<0.001; 5.22 (5.00, 5.45) mmol/L, P<0.001; 11.30 (8.33, 14.82) mU/L, P<0.001; 2.61 (1.86, 3.48), P<0.001; 14.00 (10.00, 20.00) mmol/L, P<0.001; 4.8% (38/800), P<0.001]. Basal follicle-stimulating hormone [6.58 (5.64, 7.73) U/L], basal estradiol [133.01 (102.35, 171.56) pmol/L], basal luteinizing hormone [4.80 (3.62, 6.53) U/L] and high-density lipoprotein cholesterol [1.29 (1.17, 1.39) mmol/L] in obese group were significantly lower than those in non-obese group [6.91 (5.86, 8.33) U/L, P<0.001; 145.52 (105.23, 187.95) pmol/L, P=0.001; 5.16 (3.82, 6.94) U/L, P=0.022; 1.45 (1.36, 1.55) mmol/L, P<0.001]. 2) The initiated dosage of gonadotropin (Gn) used [187.50 (150.00, 225.00) U] and the total dosage of Gn used [2 481.25 (1 856.25, 3 225.00) U] in obese group were significantly higher than those in non-obese group [225.00 (175.00, 250.00) U, P<0.001; 2 925.00 (2 250.00, 3 675.00) U, P<0.001]. Serum estradiol level on the day of human chorionic gonadotropin (hCG) injection [8 984.00 (6 087.75, 11 978.25) pmol/L], luteinizing hormone level on the day of hCG injection [1.23 (0.87, 1.79) U/L], the rate of blastocyst formation [55.56% (33.33%, 75.00%)] in obese group were significantly lower than those in non-obese group [9 378.50 (6 528.50, 12 624.50) pmol/L, P=0.016; 1.37 (0.94, 2.01) U/L, P=0.001; 60.00% (37.86%, 80.00%), P=0.014]. 3) Sustained pregnancy rate in obese group [41.5% (308/742)] was lower than that in non-obese group [47.6% (381/800), P=0.016]. The number of embryo transfer, embryo transfer type, implantation rate, clinical pregnancy rate, abortion rate and live birth rate were not statistically significant between the two groups (all P>0.05). 4) BFP was not an independent factor of clinical pregnancy rate and live birth rate (all P>0.05). 5) The area under the curve (AUC) of BMI and BFP to predict clinical pregnancy was 0.509 and 0.518, and there was no significant difference between them (AUC difference=0.009, 95% CI: -0.010-0.028, P=0.376). The AUC of BMI and BFP for predicting live birth was 0.501 and 0.513, with no statistically significant difference (AUC difference=0.012, 95% CI: -0.007-0.030, P=0.221). Conclusion:High BFP can increase total dosage of Gn used, decrease blastocyst formation rate and continuous pregnancy rate.
