肥胖與人工生殖

 

 

生育與絕育2011 Aug 5. 搶鮮版

 

來自美國的研究

 

肥胖的效應對輔助人工生殖技術成果的影響

 

：一個全國性的研究。

摘要
目的：評價肥胖對女性的反應和結果的人工輔助生殖技術（ART）的治療的影響。

設計：歷史性的世代研究

設定：診所為基礎的數據。

病人（S）：共152,500 人工輔助生殖技術(ART)週期開始從社會的人工輔助生殖技術的臨床結果報告系統 2007-2008年，僅限於婦女記錄的高度和分組身體質量指數（BMI [體重 /身高²]）。

干預（S）：無。

主要觀察指標（S）：取消整週期，取消週期由於低反應，治療失敗（沒有懷孕與懷孕），和妊娠失敗（流產或死胎與活產），經調整的比值比和95％的信心間隔，週期之間的正常體重的婦女作為對照組。

結果：全週期取消全和取消由於預行取卵而對排卵藥低反應顯著與增加BMI相關。治療失敗的機率大幅上升與自體新鮮週期，從 1.03個週期中超重的婦女（BMI 25.0-29.9），以1.53的週期與女性的BMI≥50.0公斤/米²。同樣，懷孕失敗的機率是最重要的增加體重的婦女與自體新鮮週期，提高1.10個週期從超重婦女 2.29個週期，以婦女為 BMI≥50.0公斤/米²。

結論（S）：這些結果表明肥胖者週期取消機率明顯高於正常人。此外，治療和妊娠失敗的增加明顯增加肥胖與超重的婦女有關。

 

PS:人工生殖前該減肥了，把BMI控制在18-22最佳。

 

Fertil Steril. 2011 Aug 5. [Epub ahead of print]

The effect of increasing obesity on the response to and outcome of assisted reproductive technology: a national study.

Luke B, Brown MB, Missmer SA, Bukulmez O, Leach R, Stern JE; a Society for Assisted Reproductive Technology writing group.

Source

Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University, East Lansing and Grand Rapids, Michigan; Department of Epidemiology, Michigan State University, East Lansing, Michigan.

Abstract

OBJECTIVE:

To evaluate the effect of increasing female obesity on response to and outcome of assisted reproductive technology (ART) treatment.

DESIGN:

Historical cohort study.

SETTING:

Clinic-based data.

PATIENT(S):

A total of 152,500 ART cycle starts from the Society for Assisted Reproductive Technology Clinical Outcomes Reporting System for 2007-2008, limited to women with documented height and grouped by body mass index (BMI, [weight/height(2)]).

INTERVENTION(S):

None.

MAIN OUTCOME MEASURE(S):

Cycle cancellation overall, cycle cancellation due to low response, treatment failure (not pregnant vs. pregnant), and pregnancy failure (fetal loss or stillbirth vs. live birth), as adjusted odds ratios and 95% confidence intervals, with cycles among normal-weight women as the reference group.

RESULT(S):

Cycle cancellation overall and cancellation due to low response using autologous oocytes significantly paralleled increasing BMI. The odds of treatment failure rose significantly with autologous-fresh cycles, from 1.03 for cycles among overweight women (BMI 25.0-29.9) to 1.53 for cycles among women with BMIs ≥50.0 kg/m(2). Likewise, the odds of pregnancy failure were most significant with increasing BMI among women with autologous-fresh cycles, increasing from 1.10 for cycles to overweight women to 2.29 for cycles to women with BMI ≥50.0 kg/m(2).

CONCLUSION(S):

These results indicate significantly higher odds of cycle cancellation. In addition, treatment and pregnancy failures with increasing obesity significantly increased starting with overweight women.