The impact of central obesity on the pregnancy outcomes in infertile women undergoing in vitro fertilization-embryo transfer
Objective To investigate the impact of central obesity on the pregnancy outcomes in infertile women undergoing in vitro fertilization-embryo transfer.Methods A total of 2 801 infertile women who underwent vitro fertilization-embryo transfer for the first time in the Centre for Reproductive Medicine of the First Affiliated Hospital of Wenzhou Medical University from October 2017 to September 2019 were retrospectively selected as study subjects.Based on their BMI and waist-hip ratio(WHR),patients were divided into 4 groups:normal BMI non-central obesity group(NNCO group,n=1 659),normal BMI central obesity group(NCO group,n=654),obese non-central obesity group(ONCO group,n=146),and obese central obesity group(OCO group,n=342).The dosage of gonadotropin,days of ovarian stimulation,number of oocytes retrieved,number of embryos available,and pregnancy outcomes following fresh embryo transfer were compared among the 4 groups.Multiple linear regression was used to analyze the impact of central obesity on the number of available embryos obtained during ovarian stimulation cycle,and multivariate logistic regression was used to analyze the factors affecting live birth following fresh embryo transfer.The Kaplan-Meier survival curve was used to plot the cumulative live birth rate per single egg retrieval cycle.Results Compared with the NNCO group,the OCO group had increased use of gonadotropins,fewer eggs retrieved and embryos available,lower live birth rate after fresh embryo transfer,but increased pregnancy loss rate,with a decreased cumulative live birth rate per single egg retrieval cycle(all P＜0.05).Regardless of BMI,the cumulative live birth rates per single egg retrieval cycle of WHR ≥ 0.85 central obese women were lower than that of NNCO group(both P＜0.05).Multivariate linear regression analysis indicated that WHR ≥ 0.85 significantly reduced the number of available embryos obtained during the stimulation cycle,and the multivariate logistic regression analysis found that an increased waist circumference would reduce the live birth rate after fresh embryo transfer(OR=0.978,95％CI:0.963-0.992,P=0.003).The Kaplan-Meier survival curve showed that as the number of embryo transfer cycles increased,there were statistically significant differences in the cumulative live birth rate per single egg retrieval cycle among the 4 groups(P＜0.05).Conclusion Central obesity has a negative impact on the pregnancy outcomes in infertile women undergoing in vitro fertilization-embryo transfer.
In vitro fertilization-embryo transferWaist circumferenceWaist-hip ratioCentral obesity
万方数据
维普
