CAJ | 학술논문

目的探讨高体质量指数（BMI）对多囊卵巢综合征（PCOS）患者行体外受精-胚胎移植（IVF-ET）的妊娠结局的影响。方法回顾性分析2009年1月至2011年12月于郑州大学第三附属医院生殖中心用标准长方案进行IVF助孕的224例PCOS患者资料，根据BMI分为2组，高BMI组（BMI≥24．0）60例，正常BMI组（18．5≤BMI＜24．0）164例，分析高BMI与正常BMI的PCOS患者妊娠结局的差异。结果（1）高BMI组基础睾酮（T）显著高于正常BMI组（P＜0．05）；（2）两组促性腺激素（Gn）总量、Gn用药、促排天数、获卵数、受精卵数目差异无统计学意义（P＞0．05），但高BMI组子宫内膜厚度显著高于于正常BMI组，差异有统计学意义（P＜0．05）；（3）两组临床妊娠率、胚胎种植率、流产率、平均孕周、胎儿平均体质量差异无统计学意义（P＞0．05），高BM I组妊娠期糖尿病（GDM ）显著高于正常BM I组，差异有统计学意义（ P＜0．05）。结论高BM I的PCOS患者易出现高雄激素血症，且妊娠期并发症GDM发生率增加，但不影响其临床妊娠率。
목적탐토고체질량지수（BMI）대다낭란소종합정（PCOS）환자행체외수정-배태이식（IVF-ET）적임신결국적영향。방법회고성분석2009년1월지2011년12월우정주대학제삼부속의원생식중심용표준장방안진행IVF조잉적224례PCOS환자자료，근거BMI분위2조，고BMI조（BMI≥24．0）60례，정상BMI조（18．5≤BMI＜24．0）164례，분석고BMI여정상BMI적PCOS환자임신결국적차이。결과（1）고BMI조기출고동（T）현저고우정상BMI조（P＜0．05）；（2）량조촉성선격소（Gn）총량、Gn용약、촉배천수、획란수、수정란수목차이무통계학의의（P＞0．05），단고BMI조자궁내막후도현저고우우정상BMI조，차이유통계학의의（P＜0．05）；（3）량조림상임신솔、배태충식솔、유산솔、평균잉주、태인평균체질량차이무통계학의의（P＞0．05），고BM I조임신기당뇨병（GDM ）현저고우정상BM I조，차이유통계학의의（ P＜0．05）。결론고BM I적PCOS환자역출현고웅격소혈증，차임신기병발증GDM발생솔증가，단불영향기림상임신솔。
Objective To investigate the influence of high body mass index (BMI) on in vitro fertilization and embryo transfer (IVF-ET) pregnancy outcome in the patients with polycystic ovary syndrome (PCOS) .Methods A retrospective cohort study was conducted using existing data on 224 PCOS patients with IVF-ET by the standard long protocol in this hospital from Jan 2009 to Dec 2011 .All patients were divided into 2 groups according to BMI ,the high BMI group(BMI≥24 .0 ,64 cases) and the normal BMI group(18 .5≤BMI<24 .0 ,160 cases) .The differences of pregnaney outcomes between the high BMI and normal BMI PCOS pa-tients were compared .Results 1 .Basic testosterone(T) in the high BMI group was higher than that in the normal BMI group(P<0 .05) .2 .There were no statistical difference in the number of retrived oocytes ,dose of Gn ,Gn duration ,fertilization rate between the two groups(P>0 .05);the high BMI group demonstrated the higher endometrial thickness and lower good quality embryo rate than the normal BMI group(P<0 .05) .3 .There were no statistical difference in the clinical pregnancy rate and the abortion rate be-tween the two groups(P>0 .05) ,the high BMI group had the higher risk of developing gestational diabetes(GDM)than the normal BMI group(P<0 .05) .Conclusion PCOS patient with high BMI is liable to develop hyperandrogenism and increases the occurrence rate of pregnancy complication gestational diabetes mellitus (GDM ) ,but without affecting the clinical pregnancy rate .