Obesity and poor reproductive outcome:: the potential role of the endometrium
Obesity and poor reproductive outcome:: the potential role of the endometrium
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DOI：
10.1016/j.fertnstert.2006.11.162
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发表时间：
2007-08-01
影响因子：
6.7
通讯作者：
Pellicer, Antonio
中科院分区：
文献类型：
--
作者：
Bellver, Jose;Melo, Marco A. B.;Pellicer, Antonio
目的：探讨子宫内膜等卵巢外因素对肥胖患者生育结局的影响。设计：回顾性研究。设置：大学附属不孕症诊所，2001年1月至2005年7月。患者：共接受2656个第一次卵子捐赠（OD）周期的女性，胚胎质量良好。干预措施：卵母细胞供体接受控制性超促排卵，受体接受成熟的激素替代疗法进行子宫内膜准备。根据精液特征进行体外受精（IVF）或卵胞浆内单精子注射（ICSI）。所有第一个周期（n = 2656）的卵子捐赠都使用了优质胚胎，并根据体重指数分为：< 20 kg/m2（n=471），20 - 24.9 kg/m2（n =1613），25 - 29.9 kg/m2（n =450）和>= 30 kg/m2（n = 122）。主要结局指标（S）：比较了接受者体重指数组的IVF结局。结果：植入率，怀孕，流产，并继续怀孕的体重指数组之间是相似的，虽然有一个负面的趋势时，体重指数增加。每个周期的持续妊娠率在超重和肥胖组比在体重不足和正常组差。此外，25 kg/m2以下的女性每周期的持续妊娠率为45.5%，而25 kg/m2的女性为38.3%。结论：体重过重会产生外倾性有害影响。子宫内膜或其环境的作用似乎是微妙的，但应加以考虑。（Fertil Steril（（R））2007;88：446-51. (c)2007年，美国生殖医学会（American Society for Reproductive Medicine）。
Objective: To analyze the potential role of extraovarian factors such as endometrium in the reproductive outcome of obese patients. Design: Retrospective study. Setting: University-affiliated infertility clinic, between January 2001 and July 2005. Patient(s): Women undergoing a total of 2656 first ovum donation (OD) cycles with good quality embryos. Intervention(s): The oocyte donors underwent controlled ovarian hyperstimulation, and recipients received a well-established hormonal replacement therapy for endometrial preparation. In vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) was performed according to semen characteristics. All first cycles (n = 2656) of ovum donation used good quality embryos and were divided into groups according to body mass index: < 20 kg/m(2) (n=471), 20 to 24.9 kg/m(2) (n =1613), 25 to 29.9 kg/m(2) (n =450), and >= 30 kg/m(2) (n = 122). Main Outcome Measure(S): The recipient body mass index groups were compared regarding IVF outcome. Result(s): The rates of implantation, pregnancy, miscarriage, and ongoing pregnancy were similar among the body mass index groups, although there was a negative trend when body mass index increased. Ongoing pregnancy rates per cycle were poorer in the overweight and obese groups than in the underweight and normal groups. In addition, women under 25 kg/m2 presented an ongoing pregnancy rate per cycle of 45.5%, compared with 38.3% for those with :25 kg/m(2). Conclusion(s): Excess weight exerts an extravorian detrimental effect. The role of the endometrium or its environment seems to be subtle but should be taken into account. (Fertil Steril((R)) 2007;88:446-51. (c) 2007 by American Society for Reproductive Medicine.).