Abstract:

Objective　To investigate the effect of body mass index (BMI) on clinical outcomes in female patients with intrauterine insemination (IUI). Methods　The data of the couples with the women taking IUI at Center for Reproductive Medicine, The Third Affiliated Hospital of Sun Yat-sen University from May 2020 to February 2021 were retrospectively analyzed. According to the women's BMI's, they were divided into a low weight group (BMI <18.5 kg/m²), a normal weight group (18.5 kg/m²≤BMI < 24.9 kg/m²), and an overweight group (BMI ≥ 24.9 kg/m²). There were 256 cases in the low weight group; and they were 31 (28, 33) years old. There were 1 336 cases in the normal weight group; they were 32 (29, 34) years old. There were 253 cases in the overweight group; they were 31 (28,34) years old. The basic data and clinical outcomes of IUI assisted pregnancy in the three groups were compared. U and χ² tests were applied. The logistic regression was used to analyze the relevant influencing factors of clinical pregnancy rates and live birth rates in the BMI group of the three groups of IUI. Results　There were statistical differences between the three groups in years of infertility, basal (follicle-stimulating hormone) FSH, basal luteinizing hormone (LH), infertility type, antral follicle number, and causes of infertility (all P<0.05), and no statistical differences in the women age, the total number of viable sperms in the men, and endometrial thickness of HCG (all P>0.05). The clinical pregnancy rates in the low weight group, the normal weight group, and the overweight group were 8.59% (22/256), 13.85% (185/1 336), 17.00% (43/253), and the live birth rates were 7.81% (20/256), 11.23% (150/1 336), and 14.23% (36/253), respectively; both increased with BMI; there were statistical differences (both P<0.05). The ectopic pregnancy rates in the low weight group, the normal weight group, and the overweight group were 4.55% (1/22), 5.95% (11/185), and 6.98% (3/43), and the miscarriage rates were 44.55% (1/22), 12.97% (24/185), and 9.30% (4/43), respectively, with statistical difference (both P<0.05). There was no statistical difference in the biochemical pregnancy rate between the 3 groups (P>0.05). There were statistical differences in the proportions of spontaneous cycle, oral drug stimulation cycle, and oral plus intramuscular drug stimulation cycle between the three groups (all P<0.05). Multivariate regression analysis of the clinical pregnancy rate and live birth rate showed that different BMI's between the three groups were not associated with the clinical pregnancy rate and live birth rate (both P>0.05). Conclusion　The multivariate analysis showed that BMI did not correlated with IUI, incicating that female BMI was not associated with the clinical pregnancy and live birth rates of IUI.

Key words:

Body mass index, Female, Artificial insemination, Pregnancy outcomes

摘要：

目的　探讨辅助生殖夫精宫腔内人工授精（IUI）技术对女性患者不同体质量指数（BMI）临床结局的影响。方法　回顾性分析2020年5月到2021年2月在中山大学附属第三医院生殖中心接受IUI治疗的患者双方夫妻资料。按女性BMI分成3组：低体质量组（BMI<18.5 kg/m²）、正常体质量组（18.5 kg/m²≤BMI<24.9 kg/m²）、超重组（BMI≥24.9 kg/m²）。其中，低体质量组256例，女性年龄31（28，33）岁；正常体质量组1 336例，女性年龄为32（29，34）岁；超重组253例，女性年龄31（28，34）岁。将3组行IUI助孕的患者基本资料及临床结局进行组间比较，采用U检验、χ²检验，logistic回归分析IUI 3组BMI临床妊娠率和活产率相关影响因素。结果　3组基础资料在不孕年限、基础促卵泡生成素（FSH）、基础促黄体生成素（LH）、不孕类型、窦卵泡数、不孕原因等之间的差异均有统计学意义（均P<0.05）。女方年龄、男方总活精子数、人绒毛膜促性腺激素（HCG）日内膜厚度等则差异均无统计学意义（均P>0.05）。低体质量组、正常体质量组、超重组患者的临床妊娠率分别是8.59%（22/256）、13.85%（185/1 336）、17.00%（43/253），活产率分别是7.81%（20/256）、11.23%（150/1 336）、14.23%（36/253），均随着BMI的升高而升高，且差异均有统计学意义（均P<0.05）。3组异位妊娠率分别是4.55%（1/22）、5.95%（11/185）、6.98%（3/43），流产率分别为4.55%（1/22）、12.97%（24/185）、9.30%（4/43），差异均有统计学意义（均P<0.05），其中生化妊娠率则差异无统计学意义（P>0.05）。3组患者在自然周期、口服药物促排周期、口服加肌注药物促排周期占比差异均有统计学意义（均P<0.05）。对临床妊娠率和活产率进行多因素回归分析后发现，不同BMI与临床妊娠率和活产率无关（P>0.05）。结论　BMI和IUI在多因素分析中没有发现显着关联，显示女性BMI与IUI的临床妊娠率和活产率无关。

关键词:

体质量指数, 女性, 人工授精, 妊娠结局