Obesity reduces uterine receptivity: clinical experience from 9,587 first cycles of ovum donation with normal weight donors
Obesity reduces uterine receptivity: clinical experience from 9,587 first cycles of ovum donation with normal weight donors
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DOI：
10.1016/j.fertnstert.2013.06.001
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发表时间：
2013-10-01
影响因子：
6.7
通讯作者：
Meseguer, Marcos
中科院分区：
文献类型：
--
作者：
Bellver, Jose;Pellicer, Antonio;Meseguer, Marcos
目的：根据受者体重指数分析受者的生殖结局。设计：12年回顾性队列分析。地点：生育临床。患者(S)：9587个正常体重捐卵者的第一个周期。干预(S)：受试者按体重指数分组，分析体外受精实验室和结局参数：体重指数20 kg/m(2)(n=1,458；15.2%)；正常体重体重指数20~24.9 kg/m(2)(n=5,706；59.5%)；超重体重指数25~29.9 kg/m2(n=1,770；18.5%)；肥胖者体重指数+Gt；=30 kg/m(2)(n 653；主要结局指标(S)：着床、生化和临床妊娠、流产和活产率。结果(S)：体外受精实验室参数没有因体重指数而异。然而，随着BMI的增加，植入、妊娠、临床妊娠、双胎妊娠和活产率显著降低。瘦肉组、正常体重组、超重组和肥胖组的种植率分别为40.4%、39.9%、38.5%和30.9%，临床妊娠率分别为56.9%、55.9%、54.3%和45.3%，活产率分别为38.6%、37.9%、34.9%和27.7%。但临床流产率各组间差异无统计学意义。结论：女性肥胖可能与子宫容受性降低有关。(Fertil Steril(R)2013；100：1050-8。(C)2013年，由美国生殖医学学会颁发。)
Objective: To analyze the reproductive outcome of recipients of donated ova according to their body mass index (BMI).Design: Twelve-year retrospective cohort analysis.Setting: Fertility clinics.Patient(s): 9,587 first cycles of ovum donation with ova from normoweight donors. Intervention(s): Recipients divided according to their BMI to analyze IVF laboratory and outcome parameters: lean with BMI < 20 kg/m(2) (n = 1,458; 15.2%); normoweight with BMI 20-24.9 kg/m(2) (n 5,706; 59.5%), overweight with BMI 25-29.9 kg/m2 (n = 1,770; 18.5%), and obese with BMI >= 30 kg/m(2) (n 653; 6.8%).Main Outcome Measure(s): Implantation, biochemical and clinical pregnancy, miscarriage, and live-birth rates. Result(s): In vitro fertilization laboratory parameters did not differ according to BMI. However, implantation, pregnancy, clinical pregnancy, twin pregnancy, and live-birth rates were significantly reduced as BMI increased. In the lean, normoweight, overweight, and obese groups, the implantation rate was 40.4%, 39.9%, 38.5%, and 30.9%, clinical pregnancy rate was 56.9%, 55.9%, 54.3%, and 45.3%, and live-birth rate was 38.6%, 37.9%, 34.9%, and 27.7%, respectively. However, clinical miscarriage rates were similar in all the groups.Conclusion(s): Female obesity impairs the reproductive outcome of ovum donation probably as a result of reduced uterine receptivity. (Fertil Steril (R) 2013; 100: 1050-8. (C) 2013 by American Society for Reproductive Medicine.)