| Objective:Recent years, the effect of obesity and underweight on the outcome of assisted reproduction is becoming a growing concern. The literatures haven’t reach a consensus in this regard. This article aims to explore the effect of BMI on the IVF/ICSI outcome in the patients first transplant in our center.Methods:A retrospective analysis was conducted in the patients who received assisted reproduction in our center from July 2012 to December 2013 under 35 years old, and then divided the first transplant patients into three groups:2256 cycles in group A including all patients; 1848 cycles in group B including all non-PCOS patients; 408 cycles in group C including all PCOS patients. According to BMI of national obesity standards in 2008, group A, group B and group C could be divided into four groups: low weight group(BMI <18.5kg/m2), normal weight group(18.5kg/ m2≤BMI<24kg/ m2), overweight group(24kg/ m2≤BMI<28kg/ m2), obese group(BMI≥28kg/ m2). Then compared the age, duration of infertility, type and distribution of causes of infertility, duration of infertility, distribution of infertility types, the number of basal antral follicles, the basal hormone level, the proportion of menstrual disorders, the dosage and duration of gonadotrophin(Gn), the number of retrieved oocytes, number of 2PN embryos, cleavage rate, number of transferable embryos, implantation rate, biochemical pregnancy rate, clinical pregnancy rate,abortion rate, preterm birth rate and term birth rate between groups.Result: There was no difference in patients’ age, duration of infertility, distribution of infertility types, infertility causes among groups in Group A(P>0.05). Compared with the other two groups, the basal T level was significantly higher in Group A3 and A4(P<0.01). Compared with the other three groups, the dosage and duration of gonadotrophin was significantly higher in Group A4(P<0.01). Compared with the other three groups, the number of 2PN embryos was significantly lower in Group A1(P<0.05). Compared with the other two groups, the implantation rate and clinical pregnancy rate was significantly lower in Group A3 and Group A4(P<0.01), there was no significant difference between the two groups(P>0.05). Compared with the other three groups, abortion rate was significantly higher in Group A4(P<0.01). Compared with the other two groups, the number of retrieved oocytes, number of transferable embryos and term birth rate was significantly lower in Group A1 and Group A4(P<0.01), there was no significant difference between the two groups(P>0.05).There was no difference in patients’ age, duration of infertility, distribution of infertility types, infertility causes, the number of basal antral follicles among groups in Group B(P>0.05). Compared with the other three groups, the basal T level and the dosage of gonadotrophin was significantly higher in Group B4(P<0.01). Compared with the other two groups, the number of retrieved oocytes and number of transferable embryos was significantly lower in Group B1 and Group B4(P<0.01), there was no significant difference between the two groups(P>0.05). Compared with the other three groups, abortion rate was significantly higher in Group B4(P<0.01). Compared with the other two groups, implantation rate was significantly lower in Group B3 and Group B4(P<0.01), there was no significant difference between the two groups(P>0.05). Compared with the other two groups, term birth rate was significantly lower in Group B1 and Group B4(P<0.01), there was no significant difference between the two groups(P>0.05).There was no difference in patients’ age, duration of infertility, distribution of infertility types, infertility causes among groups in Group C(P>0.05). Compared with the other two groups, the dosage and duration of gonadotrophin was significantly higher in Group C3 and Group C4(P<0.01), there was no significant difference between the two groups(P>0.05). Compared with the other two groups, the number of retrieved oocytes, number of 2PN embryos and number of transferable embryos was significantly lower in Group C3 and Group C4(P<0.01), there was no significant difference between the two groups(P>0.05). Compared with the other two groups, implantation rate and clinical pregnancy rate was significantly lower in Group C3 and Group C4 and abortion rate was significantly higher in the two groups(P<0.01), there was no significant difference among the other three groups(P>0.05).Conclusions: High or low BMI of patients under 35 years old have an adverse effect on IVF/ICSI outcome. With the increase of BMI, the dosage and duration of Gn and abortion rate increased, the implantation rate, clinical pregnancy rate and term birth rate decreased. The patients who have low BMI would have a lower number of 2PN embryos and term birth rate.For non-PCOS patients, high BMI would lead to basis hormone imbalance, endocrine disorders, menstrual disorders, the dosage of Gn and abortion rate increased, number of oocytes, number of transferred embryo, implantation rate, term birth rate decreased. Underweight patients have a lower number of oocytes, lower number of transferred embryo and term birth rate.For PCOS patients, with the increase of BMI, the dosage and duration of Gn increased, the number of oocyte and 2PN embryos and transferred embryo and implantation rate and clinical pregnancy rate decreased. The difference of term birth rate among the groups didn’t reach statistical significance, but tended to decrease. |
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