夫妻双方体重指数对体外受精结果影响

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摘要目的探究夫妻双方的体重对辅助生殖结局的影响。方法回顾性分析2008年8月~2015年10月来南京医科大学附属苏州医院生殖与遗传中心接受治疗的1223例患者，根据体重指数（BMI）进行筛选分组，根据BMI将患者分为3组：正常组（18.5~23.9 kg/m2）、超重组（>23.9~27.9 kg/m2）和肥胖组（>27.9 kg/m2）。分析患者BMI与其新鲜体外受精（IVF）周期相关性。结果经过筛选女性BMI分组中最终纳入537例患者，正常组433例，超重组79例，肥胖组25例；男性BMI分组中最终纳入805例患者，其中正常组369例，超重组299例，肥胖组137例。女性BMI分组中各组年龄、女性血清基础卵泡刺激素（FSH）水平、雌二醇（E2）水平、黄体生成素（LH）水平、BMI、促性腺激素（Gn）持续时间、男性精子浓度、活力和正常形态学精子率比较，差异无统计学意义（P > 0.05）；超重组及肥胖组Gn剂量均高于正常体重组，差异有统计学意义（P < 0.05）；男性BMI分组中，各组年龄、女性血清基础FSH水平、E2水平、LH水平、BMI、Gn剂量、Gn持续时间、男性精子浓度、活力和正常形态学精子率比较，差异均无统计学意义（P > 0.05）；男性肥胖组的受精率、种植率和妊娠率显著低于其他两组，而流产率显著高于正常组，差异均有统计学意义（P < 0.05）。结论男性BMI增加及IVF结局可能与精子DNA损伤或精子和卵母细胞间相互作用差有关，提示参与IVF治疗的夫妇，尤其是男方，需要维持适当的体重，以降低IVF结局不良的风险。

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	王家雄沈丽燕王玮李红

关键词 ：不育, 超重, 肥胖, 体外受精, 结局

Abstract：Objective To explore the impact of the weight of both husband and wife on assisted reproductive outcomes. Methods A retrospective analysis of patients undergoing treatment at the Center for Reproduction and Genetics of the Affiliated Suzhou Hospital of Nanjing Medical University from August 2008 to October 2015 was conducted. A total of 1223 fresh in vitro fertilization(IVF) cycles were collected and grouped according to body mass index (BMI), they were divided into 3 groups: normal group (BMI 18.5-23.9 kg/m2), overweight group (BMI >23.9-27.9 kg/m2), and obese group (BMI >27.9 kg/m2). An analysis of the correlation between BMI and IVF was conducted. Results After screening 537 patients were finally included in female BMI group: 433 cases in the normal group, 79 cases in the overweight group and 25 cases in the obese group. 805 patients were eventually included in the male BMI group: 369 cases in the normal group, 299 cases in the overweight group and 137 cases in the obese group. In female BMI group, the age, levels of FSH, E2, LH in female serum, BMI, duration of Gn, the concentration, vitality of male sperm and normal morphology sperm rate were compared among each group, and there was no statistically difference (P > 0.05). The dose of Gn in overweight group and obese group was higher than that in the normal weight group, and the difference was statistically significant (P < 0.05). In male BMI group, the age, basic levels of FSH, E2 and LH in female serum, BMI, dose and duration of Gn, the concentration, vitality of male sperm and normal morphology sperm rate were compared among each group, and there was no statistically difference (P > 0.05). The fertility rate, implantation rate and pregnancy rate of the male obesity group were significantly lower than those of the other two groups, while the abortion rate was significantly higher than that of the normal group, with statistically significant difference (P < 0.05). Conclusion The correlation between increased male BMI and poor IVF outcome might be due to the sperm DNA damage or poor sperm-oocyte interactions, suggesting that couples involved in IVF therapy, especially men, need to maintain an appropriate body weight to reduce poor IVF outcomes risk.

Key words： Infertility Overweight Obesity IVF outcome

基金资助:江苏省苏州市科技计划项目（SZS201718）；
江苏省苏州市科教兴卫青年科技项目（KJXW2017028）。

作者简介: 王家雄（1987.5-），男，硕士，主要从事男科学的检验与科研工作。

引用本文:

王家雄沈丽燕王玮李红. 夫妻双方体重指数对体外受精结果影响[J]. 中国医药导报, 2018, 15(20): 67-70.
WANG Jiaxiong SHEN Liyan WANG Wei LI Hong. Impact of couples′ body mass index on the in vitro fertilization outcomes. 中国医药导报, 2018, 15(20): 67-70.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I20/67

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