| Objective:At present,the influence of body mass index(BMI)on pregnancy outcome has attracted more and more attention,especially for women undergoing in vitro fertilization and embryo transfer.With the development of vitrification and freezing technology,domestic reproductive centers focus on freezing and thawing embryo transfer,but the impact of BMI on the pregnancy and neonatal outcome of patients who choose freezing and thawing single blastocyst transfer(FET)is not clear.And women with polycystic ovary syndrome(PCOS)are usually overweight or even obese.The purpose of this article is to compare the general data,cycle data,pregnancy outcome and neonatal outcome of IVF treatment of four groups of PCOS patients with different body mass index through retrospective analysis,and explore the impact of different pre-pregnancy BMI on the pregnancy outcome of PCOS patients receiving freeze-thawed single blastocyst transfer in the first cycle.Methods:A retrospective study was conducted to analyze 305 women with PCOS who first performed frozen-thawed single-cell embryo transfer in the first in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)cycle in Dalian Municipal Women And Children Medical Center.The time of collecting oocytes in the first fresh cycle was≤39 years old and no fresh transplantation was performed.A total of 305PCOS patients who met the inclusion criteria of this study were divided into four groups according to the Guidelines for the Determination of Overweight in Chinese Population:low body weight group A2(BMI<18.5kg/m2,n=15),normal weight group A1(18.5≤BMI<24kg/m2,n=145),super weight group A3(24≤BMI<28kg/m2,n=88),and obesity group A4(BMI≥28kg/m2,n=57).The general data of the four groups of patients(number of patients in each group,age of mother,type of infertility,complications),cycle data(fertilization method,number of eggs obtained,days of blastocyst formation,whether the single blastocyst transferred is high-quality blastocyst),pregnancy outcome(biochemical pregnancy,clinical pregnancy(CP),induced labor,early abortion,live birth,live birth rate(LBR),term delivery,premature delivery,macrosomia Low-weight infants and the proportion of men and women were collected and compared.Summarize the above collected data and sort them out,use Excel to make a table,and use SPSS 26.0 to carry out statistical analysis of the data.When carrying out statistical description of the data,classify the measurement data and use statistics such as mean±standard deviation,median and interquartile spacing to express;Apply counting data to describe its frequency and composition ratio of counting data;In the hypothesis test,the independent sample t-test is used for the measurement data conforming to the normality.If the verified measurement data is non-normal distribution,the rank sum test is used.The counting data is expressed in rate(%).Chi-square test or Fisher test were used for comparison between the groups,and bilateral test was set up.If P<0.05,the difference was statistically significant.Result1.Taking the normal weight group(18.5≤BMI<24kg/m~2)as the control group,the general situation of low body weight recombination(BMI<18.5kg/m~2),including the age of mother,the type of infertility and the type of complications of patients,had no statistical difference(P>0.05);There was no statistically significant difference between the two groups in the number of oocytes obtained by patients,endometrial preparation scheme,D5 blastocyst rate of transferred embryos,and high-quality blastocyst rate of transferred embryos;In the analysis of the impact on pregnancy outcome,there was no significant difference between the two groups in biochemical pregnancy rate,clinical pregnancy rate(CPR),biochemical pregnancy rate included in abnormal pregnancy,early abortion rate(MR),induced labor rate,live birth rate(LBR),premature birth rate,term birth rate,macrosomia birth rate,male and female birth rate in neonatal outcome(P>0.05);There was a significant difference in the birth rate of low birth weight infants between the two groups(P<0.05).2.Taking the normal weight group as the control group,there was no significant difference between the overweight(24≤BMI<28kg/m~2)and the normal weight group(P>0.05);There was no significant difference in the number of oocytes obtained,the preparation of endometrium,the rate of D5 blastocyst and the rate of high-quality blastocyst;In the analysis of pregnancy outcome,there was no significant difference between the two groups in biochemical pregnancy rate,CPR,biochemical pregnancy rate in abnormal pregnancy,MR,induced labor rate,LBR,term rate in neonatal outcome,low birth weight rate,macrosomia rate,and male birth rate(P>0.05).3.Taking the normal weight group as the control group,the obesity group(BMI≥28kg/m~2)had no significant difference in general conditions including maternal age,type of infertility and complications(P>0.05);There was no statistically significant difference between the number of oocytes obtained by patients,the preparation scheme of endometrium,the rate of D5 blastocyst for transferred embryos,and the rate of high-quality blastocyst for transferred embryos;In the analysis of pregnancy outcome,there was no statistically significant difference between the two groups in biochemical pregnancy rate,CPR,biochemical pregnancy rate in abnormal pregnancy,induced labor rate,term birth rate,low birth weight infant rate in neonatal outcome,and male birth rate(P>0.05).There were significant differences in MR,LBR and birth rate of macrosomia between the two groups(P<0.05)Conclusion:Pre-pregnancy low weight of patients with PCOS will increase the birth rate of low weight infants,while obesity has a negative impact on the pregnancy outcome of PCOS patients.Therefore,weight adjustment should be carried out for these two types of patients before pregnancy in order to expect a better pregnancy outcome. |
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