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目的 探讨女性不同体质量指数（BMI）与体外受精/卵胞质内单精子注射（IVF/ICSI）助孕过程关键指标的相关性及其对产科结局的影响。方法 回顾性分析接受IVF/ICSI治疗的患者资料，采用倾向性得分匹配平衡组间差异后，入组周期19 834例。依据中国人群BMI标准并延伸，将患者分为：极低体质量组（BMI<16）、偏低体质量组（16.0≤BMI<18.5）、正常体质量组（18.5≤BMI<24.0）、超重组（24.0≤BMI<28.0）和肥胖组（BMI≥28.0）。比较5组患者的基本情况、促排方案及过程、助孕结局。另外，后期随访到75例已分娩且有并发症的患者，分析BMI影响妊娠期并发症的关联性。结果 5组患者一般资料比较中，各组间年龄、不孕年限、双窦卵泡数等基本情况的差异均无统计学意义。促排方案及过程比较中，各组间IVF卵子数的差异有统计学意义（P<0.001），正常组显著高于超重组和肥胖组。助孕结局比较中，生化妊娠率、出生缺陷率的差异无统计学意义。各组间累积活产率的差异有统计学意义（P<0.05），超重组显著高于正常组。随访到的75例患者中，妊娠期高血压25例，妊娠合并糖尿病22例（两并发症中超重和肥胖分别占60.00%、45.40%）。结论 女性不同BMI与IVF/ICSI结局存在显著关联。极低体质量患者孕前体质量评估应予以重视；超重和肥胖患者的活产率较正常体质量组相当，但仍建议这类人群治疗前积极减重，减少流产、早产和妊娠并发症的发生率。
Abstract：Objective To investigate the correlation between different female body mass index(BMI) values and key indicators of in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI) treatment cycles, as well as their impact on obstetric outcomes.Methods A retrospective analysis was conducted on data from patients who underwent IVF/ICSI treatment, with 19 834 cycles included after propensity score matching to balance group differences. Based on the Chinese BMI classification standards with extended categories, patients were stratified into five groups: severely underweight(BMI<16), underweight(16. 0≤BMI<18. 5), normal weight(18. 5≤BMI<24. 0), overweight(24. 0≤BMI<28. 0), and obese(BMI≥28. 0). Baseline characteristics, ovarian stimulation protocols, treatment processes, and assisted reproductive outcomes were compared among the groups. Additionally, 75 delivered patients with complications were followed up to analyze the association between BMI and pregnancy-related complications.Results No statistically significant differences were observed among the five groups in baseline parameters such as age, duration of infertility, or antral follicle count. Regarding ovarian stimulation protocols and processes, a statistically significant difference was found in the number of IVF oocytes retrieved(P<0. 001), with the normal-weight group showing a significantly higher number than both the overweight and obese groups. In terms of assisted reproductive outcomes, no significant differences were observed in biochemical pregnancy rates or birth defect rates. However, cumulative live birth rates differed significantly among the groups(P<0. 05), which was significantly higher in the overweight group than in the normal-weight group. Among the 75 followed-up patients, 25 were diagnosed with gestational hypertension, and 22 with gestational diabetes mellitus, of whom overweight and obese individuals accounted for 60. 00% and 45. 40% of the respective complications.Conclusion Female BMI is significantly associated with IVF/ICSI outcomes. Pre-pregnancy body mass evaluation should be emphasized in patients with extremely low body weight. Although the live birth rate of overweight and obese patients was comparable to that of the normal-weight group, weight reduction prior to treatment is strongly recommended to minimize risks of miscarriage, preterm birth, and pregnancy complications.
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基本信息:
DOI：10.19405/j.cnki.issn1000-1492.2026.08.018
中图分类号:R714.8
引用信息:
[1]张惠茹,张媛媛,尹奕琪,等.女性不同体质量指数影响IVF/ICSI结局的分析[J].安徽医科大学学报,2026(08):1464-1471.DOI:10.19405/j.cnki.issn1000-1492.2026.08.018.
基金信息:
国家自然科学基金项目(编号:U24A20764)
2026-07-22
2026-07-22
2026-07-22