Influence of menstrual cycle regularity on ovarian response and early embryonic development in conventional IVF among overweight/obese patients
Objective:To investigate the effect of menstrual cycle regularity on ovarian response and early embryonic development in conventional IVF among overweight and obese patients.Methods:A retrospective study was conducted to analyze the data of couples who underwent the first cycle of conventional IVF in Renmin Hospital of Wuhan University from January 2021 to August 2023.According to the body mass index(BMI),the patients were divided into normal BMI group(group A,18.5 kg/m2≤BMI≤23.9 kg/m2,n=975)and overweight/obesity group(group B,BMI≥24 kg/m2,n=422).According to the regularity of menstrual cycle,the patients in group B were further divided into regular menstrual cycle group(group B1,21 d ≤menstrual cycle ≤35 d,n=251)and irregular group(group B2,menstrual cycle<21 d and/or menstrual cycle>35 d,n=171).Results:There were no significant differences in age,type of infertility and anti-Müllerian hormone(AMH)level between group A and group B(P>0.05).The years of infertility,menstrual cycle,and antral follicle count(AFC)in group B were significantly higher than those in group A,while the levels of basic sex hormones regarding estradiol(E2),LH,FSH,progesterone(P)were significantly lower than those in group A(P<0.05).There was a significant difference in the cause of infertility between the two groups(P<0.05).Compared with group A,the initiation and total gonadotropin(Gn)doses and the total days of Gn use in group B were significantly higher(P<0.05).There were no significant differences in the treatment protocol,the number of oocytes retrieved and early embryonic development between the two groups(P>0.05).Furthermore,compared with patients in group Bl,patients in group B2 were significantly younger,and higher BMI as well as longer infertility years and menstrual cycle days were found(P<0.05).There were significant differences in AFC,levels of AMH and basic sex hormones(LH,FSH,P)and the cause of infertility between the two groups(P<0.05).There was significant difference in the treatment protocol between the two groups(P<0.05),and the percentage of antagonist protocol use was higher in group B2.The rate of D3 high-quality embryo of group B2 was significantly lower than that of group B1(P<0.05).And there were no significant differences in other indicators of early embryo development.Conclusions:The ovarian responsiveness of overweight/obese women decreased and had no effect on early embryonic development in IVF,while the ovarian responsiveness of overweight/obese patients with irregular menstrual cycle relatively increased,which had an adverse effect on the development of D3 high-quality embryo during IVF.
Body mass indexMenstrual cycleOvarian responseIVFEmbryonic development