血脂异常对非PCOS患者体外受精-胚胎移植妊娠结局的影响

doi:10.3760/cma.j.issn.1007-1245.2022.23.029

国际医药卫生导报 ›› 2022, Vol. 28 ›› Issue (23): 3376-.DOI: 10.3760/cma.j.issn.1007-1245.2022.23.029

血脂异常对非PCOS患者体外受精-胚胎移植妊娠结局的影响

程玲颜晓红李友筑

厦门大学附属第一医院生殖医学科，厦门　361003

收稿日期:2022-08-29 出版日期:2022-12-01 发布日期:2022-12-17
通讯作者: 李友筑，Email：232398106@qq.com

Effect of dyslipidemia on pregnancy outcomes in non-PCOS patients undergoing in vitro fertilization-embryo transfer

Cheng Ling, Yan Xiaohong, Li Youzhu

Department of Reproductive Medicine, The First Hospital of Xiamen University, Xiamen 361003, China

Received:2022-08-29 Online:2022-12-01 Published:2022-12-17
Contact: Li Yuozhu, Email: 232398106@qq.com

摘要/Abstract

摘要： 目的　探讨血脂异常对非多囊卵巢综合征（polycystic ovarian syndrome，PCOS）患者体外受精-胚胎移植妊娠结局的影响。方法　收集2016年12月至2020年12月就诊于厦门大学附属第一医院生殖医学科，进行体外受精（in vitro fertilization，IVF）或卵胞浆内单精子注射（intracytoplasmic sperm injection，ICSI）治疗的677对非PCOS不孕夫妇的临床资料，按女方血脂水平进行分为血脂正常组［556例，年龄（29.32±3.03）岁］和血脂异常组［121例，年龄（29.68±2.83）岁］，分析两组一般资料和妊娠结局。组间比较采用独立样本t检验、χ²检验或Fisher确切概率法。结果　血脂异常组患者的体质量指数（BMI）、不孕年限、促性腺激素（Gn）天数和Gn总量高于血脂正常组，差异均有统计学意义（均P<0.05），女方年龄、男方年龄、基础卵泡刺激素（FSH）、基础黄体生成素（LH）、基础雌二醇（E₂）、人绒毛膜促性腺激素（HCG）日E₂水平、HCG日孕酮（P）水平、HCG日内膜厚度、受精方式和不孕情况在两组间比较，差异均无统计学意义（均P>0.05）。血脂异常组的活产率（41.89%，31/74）低于血脂正常组（55.32%，156/282）、流产率（22.50%，9/40）高于血脂正常组（10.86%，19/175），两组比较，差异均有统计学意义（χ²=4.238、4.896，均P<0.05）。获卵数、MII卵数、受精率、移植胚胎数、婴儿体质量、妊娠率、种植率、早产率、移植胚胎类型、新生儿性别、新生儿体质量比例在两组间之间比较，差异均无统计学意义（均P>0.05）。结论　血脂异常可导致非PCOS不孕患者活产率降低和流产率增高，在接受辅助生殖治疗之前，将血脂水平控制在正常水平可获得较好的妊娠结局。

关键词: 血脂异常, 体外受精-胚胎移植, 活产率, 流产率, 辅助生殖

Abstract: Objective　To investigate the effect of dyslipidemia on pregnancy outcomes in patients with non-polycystic ovarian syndrome (PCOS) undergoing in vitro fertilization-embryo transfer. Methods　The clinical data of 677 non-PCOS infertile couples who attended Department of Reproductive Medicine, The First Hospital of Xiamen University from December 2016 to December 2020 and underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) were collected. They were divided into a normal lipid group (556 cases) who were (29.32±3.03) years old and an abnormal lipid group (121cases) who were (29.68±2.83) years old according to the female lipid level. The general data and pregnancy outcomes in both groups were analyzed. The data were compared between these two groups by independent-sample t test, χ² test, and Fisher's precision probability test. Results　The body mass index (BMI), years of infertility, gonadotropin (Gn) days, and total Gn in the abnormal lipid group were higher than those in the normal lipid group, with statistical significant differences (all P<0.05). There were no statistical differences in female age, male age, basal follicle stimulating hormone (FSH), basal luteinizing hormone (LH), basal estradiol (E₂), human chorionic gonadotropin (HCG) daily E₂ level, HCG daily progesterone (P) level, HCG daily endometrial thickness, mode of fertilization, and infertility between the two groups (all P>0.05). The live birth rate in the abnormal lipid group was lower than that in the normal lipid group [41.89% (31/74) vs. 55.32% (156/282)], and the miscarriage rate in the abnormal lipid group was higher than in the normal lipid group [22.50% (9/40) vs. 10.86% (19/175)], with statistical differences (χ²=4.238 and 4.896, both P<0.05). There were no statistical difference in the number of eggs obtained, number of MII eggs, fertilization rate, number of embryos transferred, infant weight, pregnancy rate, implantation rate, preterm birth rate, type of embryos transferred, newborn gender, and newborn weight ratio between the two groups (all P>0.05). Conclusion　Dyslipidaemia can lead to a lower live birth rate and a higher miscarriage rate in non-PCOS infertile patients, and controlling lipid levels to normal prior to assisted reproductive treatment may have better pregnancy outcomes.

Key words: Dyslipidemia, In vitro fertilization-embryo transfer, Live birth rate, Miscarriage rate, Assisted reproduction

程玲颜晓红李友筑. 血脂异常对非PCOS患者体外受精-胚胎移植妊娠结局的影响[J]. 国际医药卫生导报, 2022, 28(23): 3376-.

Cheng Ling, Yan Xiaohong, Li Youzhu. Effect of dyslipidemia on pregnancy outcomes in non-PCOS patients undergoing in vitro fertilization-embryo transfer[J]. International Medicine and Health Guidance News, 2022, 28(23): 3376-.

参考文献

[1] Zeyneloglu HB, Tohma YA, Gunakan E,et al. Diet and pravastatin administration prior to in vitro fertilization treatment may improve pregnancy outcome in women with dyslipidemia[J]. J Obstet Gynaecol, 2022,42(6):2235-2240. DOI: 10.1080/01443615.2022.2036968.
[2] Raviv S, Hantisteanu S, Sharon SM, et al. Lipid droplets in granulosa cells are correlated with reduced pregnancy rates[J]. J Ovarian Res, 2020,13(1):4. DOI: 10.1186/s13048-019-0606-1.
[3] Palomba S, Piltonen TT, Giudice LC. Endometrial function in women with polycystic ovary syndrome: a comprehensive review[J]. Hum Reprod Update, 2021,27(3):584-618. DOI: 10.1093/humupd/dmaa051.
[4] Gao L, Li M, Wang Y, et al. Overweight and high serum total cholesterol were risk factors for the outcome of IVF/ICSI cycles in PCOS patients and a PCOS-specific predictive model of live birth rate was established[J]. J Endocrinol Invest, 2020,43(9):1221-1228. DOI: 10.1007/s40618-020-01209-5.
[5] 中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中国循环杂志,2016,31(10):937-950.DOI:10.3969/j.issn.1000-3614. 2016.10.001.
[6] Yang T, Zhao J, Liu F, et al. Lipid metabolism and endometrial receptivity[J]. Hum Reprod Update, 2022,28(6):858-889. DOI: 10.1093/humupd/dmac026.
[7] Hohos NM, Cho KJ, Swindle DC, et al. High-fat diet exposure, regardless of induction of obesity, is associated with altered expression of genes critical to normal ovulatory function[J]. Mol Cell Endocrinol, 2018,470:199-207. DOI: 10.1016/j.mce.2017.10.016.
[8] Skaznik-Wikiel ME, Swindle DC, Allshouse AA, et al. High-fat diet causes subfertility and compromised ovarian function independent of obesity in mice[J]. Biol Reprod, 2016,94(5):108. DOI: 10.1095/biolreprod. 115.137414.
[9] Morel Y, Roucher F, Plotton I, et al. Evolution of steroids during pregnancy: maternal, placental and fetal synthesis[J]. Ann Endocrinol (Paris), 2016,77(2):82-89. DOI: 10.1016/j.ando.2016.04.023.
[10] Delhaes F, Giza SA, Koreman T, et al. Altered maternal and placental lipid metabolism and fetal fat development in obesity: Current knowledge and advances in non-invasive assessment[J]. Placenta, 2018,69:118-124. DOI: 10.1016/j.placenta.2018.05.011.
[11] Yang T, Zhao J, Zhang Q, et al. Associations between dyslipidaemia and pregnancy outcomes in the first complete cycle of IVF/ICSI: a real-world analysis[J]. Reprod Biomed Online, 2021,43(6):1095-1105. DOI: 10.1016/j.rbmo.2021.08.030.
[12] Cai WY, Luo X, Chen E, et al. Serum lipid levels and treatment outcomes in women undergoing assisted reproduction: a retrospective cohort study[J]. Front Endocrinol (Lausanne), 2021,12:633766. DOI: 10.3389/fendo.2021.633766.
[13] Jamro EL, Bloom MS, Browne RW, et al. Preconception serum lipids and lipophilic micronutrient levels are associated with live birth rates after IVF[J]. Reprod Biomed Online, 2019,39(4):665-673. DOI: 10.1016/j.rbmo.2019.06.004.
[14] Liu Z, Cong J, Liu X, et al. Dyslipidemia is negatively associated with the cumulative live-birth rate in patients without PCOS following IVF/ICSI[J]. Front Physiol, 2021,12:713356. DOI: 10.3389/fphys.2021.713356.
[15] 滕文顶,张攀,鲜红,等.女性血脂异常对体外受精胚胎质量及妊娠结局的影响分析[J].中国计划生育和妇产科,2018,10(4):78-81.DOI:10.3969/j.issn.1674-4020.2018.04.19.

血脂异常对非PCOS患者体外受精-胚胎移植妊娠结局的影响

Effect of dyslipidemia on pregnancy outcomes in non-PCOS patients undergoing in vitro fertilization-embryo transfer

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 2

编辑推荐

Metrics

[1]	谭鸿霞文娟宋悦龄. 辅助生殖妊娠后先兆流产患者延续性护理的需求分析[J]. 国际医药卫生导报, 2022, 28(23): 3407-.
[2]	程玲. 男方年龄对冻融胚胎移植周期妊娠结局的影响[J]. 国际医药卫生导报, 2022, 28(21): 2985-2989.