Objective:To investigate the impact and predictive value of bone morphogenetic protein-15(BMP-15)levels in follicular fluid on the quality of embryos in patients with simple obesity undergoing in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI).Methods:A total of 118 infertile patients who underwent IVF/ICSI at the Reproductive Medicine Center of our hospital from June 2022 to June 2023 were enrolled.Based on body mass index(BMI),patients were divided into 3 groups:control group(18.5 kg·m-2≤BMI<24 kg·m-2),overweight group(24 kg·m-2≤BMI<28 kg·m-2),and obese group(BMI≥28 kg·m-2).All patients underwent ovarian stimulation using the antagonist protocol.Serum was collected on day 3 of menstruation,and BMP-15 levels in follicular fluid on the day of oocyte retrieval were measured using enzyme-linked immunosorbent assay(ELISA).Results:Compared to the control group,anti-Müllerian hormone(AMH)and baseline progesterone(bP)levels were significantly lower in the obese group,while baseline follicle-stimulating hormone(bFSH)levels were lower in both the obese and overweight groups(P<0.05).The amount of gonadotropins(Gn)required significantly increased with BMI,and BMP-15 levels in follicular fluid significantly decreased(P<0.05).The total number of retrieved oocytes,Metaphase Ⅱ(MⅡ)rate,blastocyst formation rate,and high-quality embryo rate were all lower in the obese group compared to the control and overweight groups(P<0.05).In non-obese patients,the high BMP-15 group had higher fertilization,high-quality embryo,and blastocyst formation rates compared to the low BMP-15 group(P<0.05).Among obese patients,the high BMP-15 group had higher MⅡ,fertilization,high-quality embryo,and blastocyst formation rates than the low BMP-15 group(all P<0.05).In obese patients,BMP-15 levels in follicular fluid were positively correlated with MⅡ rate,fertilization rate,high-quality embryo rate,and blastocyst formation rate.Multivariate Logistic regression analysis showed that BMP-15,AMH,and bFSH were independent influencing factors for embryo quality in obese patients(P<0.05).The combined detection of BMP-15 and bFSH demonstrated better predictive performance for embryo quality outcomes than individual detection(P<0.05).Conclusion:Obesity reduces BMP-15 expression in follicular fluid of women of reproductive age,negatively affecting embryo quality.The combined detection of follicular fluid BMP-15 and serum bFSH has reliable predictive value for embryo quality in women with simple obesity.
bone morphogenetic protein-15body mass indexfollicular fluidin vitro fertilization/intracytoplasmic sperm injectionquality of embryos
维普
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