目的:探讨育龄期女性体重指数对胚胎发育及助孕结局的影响,旨在为不同体重指数的患者提供更好的助孕治疗,为临床诊疗提供参考。方法:回顾性收集2015年1月~2021年10月在海南医学院第一附属医院生殖医学中心首次接受鲜胚移植且通过长方案...目的:探讨育龄期女性体重指数对胚胎发育及助孕结局的影响,旨在为不同体重指数的患者提供更好的助孕治疗,为临床诊疗提供参考。方法:回顾性收集2015年1月~2021年10月在海南医学院第一附属医院生殖医学中心首次接受鲜胚移植且通过长方案促排的患者资料,共3783例。按照体重指数(body mass index,BMI)将患者分为:低体重组(BMI<18.5 kg/m^(2))、正常体重组(18.5≤BMI<24 kg/m^(2))、超重组(24≤BMI<28 kg/m^(2))和肥胖组(BMI≥28 kg/m^(2))。比较四组的基本情况、助孕过程、胚胎发育以及助孕结局。结果:分析患者基本情况发现,四组女性年龄无显著差异(P>0.05),但肥胖女性的不孕时间显著延长(P=0.007)。超重及肥胖组的基础内分泌水平低于正常组(P<0.05)。肥胖组基础卵泡刺激素(follicle-stimulating hormone,FSH)、基础黄体生成素(luteinizing hormone,LH)、基础雌二醇(estradiol,E2)、基础孕酮(progesterone,P)、抗缪勒管激素(anti-mullerian hormone,AMH)均低于正常体重组(P<0.05),肥胖组基础窦卵泡数(antral follicle counting,AFC)减少(P=0.011)。超重组仅表现为E2、P水平降低(P<0.05)。在助孕过程中,肥胖组促性腺激素(gonadotropin,Gn)用量最多,超重组次之,低体重组最少(P<0.001)。肥胖组的Gn天数延长(P<0.001)。超重、肥胖组扳机日LH、E2、P均低于正常体重组(P<0.05)。比较胚胎发育过程得出,肥胖组囊胚在原核消失(time of pronuclei disappearance,tPNf)、四细胞(time of four cells,t4)及囊胚形成(time of full blastocyst,tB)阶段均出现发育延迟(P<0.05)。肥胖组助孕结局较差,表现为临床妊娠率(P=0.044)及活产率(P=0.036)降低。行二分类Logistic回归分析后发现,肥胖是临床妊娠(OR=0.683,95%CI:0.479-0.973,P=0.035)及活产(OR=0.662,95%CI:0.459-0.954,P=0.027)的危险因素。年龄为生化妊娠、临床妊娠和活产的危险因素(P<0.05)。结论:女性肥胖延长不孕时间,引起内分泌紊乱,增加Gn用量及天数。女性肥胖能延迟囊胚发育过程,为临床妊娠及活产的危险因素。展开更多
Objective:To investigate the effects of female body mass index on embryo development and assisted reproductive technology outcomes,aiming to provide better treatment for patients with different body mass index and pro...Objective:To investigate the effects of female body mass index on embryo development and assisted reproductive technology outcomes,aiming to provide better treatment for patients with different body mass index and provide reference for clinical treatment.Methods:The study retrospectively collected data of 3783 patients who received their first fresh embryo transfer and were ovulated by a long protocol at the Reproductive Medicine Center of the First Affiliated Hospital of Hainan Medical University from January 2015 to October 2021.Patients were divided into four groups based on body mass index(BMI):low weight group,normal weight group,overweight group and obese group.The normal weight group was used as a control to compare the basic information,assisted reproductive technology process,embryo development and assisted reproductive technology outcomes between different groups.Results:Analyzing patients'basic information,we found that the duration of infertility was significantly longer in obese women(P=0.007).Basal hormone levels in the overweight and obese groups were lower than those in the normal group(P<0.05).Basal Follicle-stimulating hormone(FSH),basal Luteinizing hormone(LH),basal Estradiol(E2),basal Progesterone(P),and anti-Mullerian hormone(AMH)in the obese group were lower than the normal weight group(P<0.05),and the number of antral follicle counting(AFC)was reduced in the obese group(P=0.011).The overweight group only showed a decrease in E2 and P levels(P<0.05).During the ART,there was a significant difference in Gonadotropin(Gn)dosage among the four groups,with the obese group was the most,followed by the overweight group,and the low weight group was the least(P<0.001).Gn days were increased in the obese group(P<0.001).LH,E2,and P on trigger day were all lower in the overweight and obese groups than in the normal weight group(P<0.05).Comparing the embryo development process,we found that the blastocysts of the obese group showed delayed development at the stages of pronuclei disappearance,four-cell and blastocyst formation(P<0.05).The ART outcomes were worse in the obese group,the clinical pregnancy rate(P=0.044)and live birth rate(P=0.036)were reduced in the obese group.After logistic regression,obesity was found to be a risk factor for clinical pregnancy(OR=0.683,95%CI:0.479-0.973,P=0.035)and live birth(OR=0.662,95%CI:0.459-0.954,P=0.027).Female age was a risk factor for biochemical pregnancy,clinical pregnancy and live birth(P<0.05).Conclusion:Female obesity prolongs the duration of infertility,causes endocrine disorders,increases Gn dosage and days,and leads to poorer assisted reproductive technology outcomes.Female obesity delays the blastocyst development process and presents as a risk factor for clinical pregnancy and live birth.展开更多
目的探讨多房棘球蚴不同感染时间小鼠肝组织细胞外基质蛋白1(extracellular matrix protein 1,ECM1)的表达水平以及与肝纤维化过程的相关性。方法将40只雌性C57BL/6小鼠随机分为多房棘球蚴感染组和对照组(20只/组),感染组经肝门静脉接种...目的探讨多房棘球蚴不同感染时间小鼠肝组织细胞外基质蛋白1(extracellular matrix protein 1,ECM1)的表达水平以及与肝纤维化过程的相关性。方法将40只雌性C57BL/6小鼠随机分为多房棘球蚴感染组和对照组(20只/组),感染组经肝门静脉接种2000个原头节/鼠,对照组注射等量生理盐水。分别于感染后第1、6、12和24周,两组各取5只小鼠采集肝组织,切片后HE染色观察多房棘球蚴感染后小鼠肝组织病理学变化;天狼星红染色以及α-SMA染色检测小鼠肝纤维化程度;免疫组织化学染色检测肝组织中ECM1的表达水平与分布。采用Pearson相关系数法分析ECM1表达水平与肝纤维化水平的相关性。结果HE染色结果显示,多房棘球蚴感染后6周,小鼠肝组织内可见具有明显生发层结构的病灶形成,周围炎性细胞浸润明显且伴有纤维组织增生。天狼星红染色结果显示,感染组小鼠肝组织内病灶周围胶原沉积面积占比在感染后1、6、12和24周分别为(6.97±0.07)%、(10.39±0.02)%、(17.31±1.78)%和(22.24±1.07)%,均高于对照组(P<0.05);α-SMA染色结果显示,感染组肝组织病灶周围α-SMA阳性染色面积占比在感染后1、6、12和24周分别为(5.31±0.39)%、(9.97±1.3)%、(16.16±0.17)%和(19.01±0.49)%,均高于对照组(P<0.05);且随着多房棘球蚴感染小鼠时间的延长病灶周围肝纤维化程度不断加重。免疫组化检测结果显示,ECM1主要表达在病灶周围的炎性细胞带中,少量表达在肝窦;感染组ECM1阳性染色面积占比在感染后1、6、12和24周分别为(8.60±0.44)%、(13.90±0.57)%、(16.37±0.77)%和(19.50±0.50)%,均高于对照组(P<0.05)。Pearson相关性分析显示,ECM1表达水平与天狼星红阳性染色区域面积(r=0.900,P<0.01)及α-SMA阳性染色区域面积占比(r=0.941,P<0.01)均呈正相关。结论ECM1在多房棘球蚴不同感染时间小鼠肝组织的表达均较对照组升高,并与肝纤维化程度呈正相关。展开更多
文摘目的:探讨育龄期女性体重指数对胚胎发育及助孕结局的影响,旨在为不同体重指数的患者提供更好的助孕治疗,为临床诊疗提供参考。方法:回顾性收集2015年1月~2021年10月在海南医学院第一附属医院生殖医学中心首次接受鲜胚移植且通过长方案促排的患者资料,共3783例。按照体重指数(body mass index,BMI)将患者分为:低体重组(BMI<18.5 kg/m^(2))、正常体重组(18.5≤BMI<24 kg/m^(2))、超重组(24≤BMI<28 kg/m^(2))和肥胖组(BMI≥28 kg/m^(2))。比较四组的基本情况、助孕过程、胚胎发育以及助孕结局。结果:分析患者基本情况发现,四组女性年龄无显著差异(P>0.05),但肥胖女性的不孕时间显著延长(P=0.007)。超重及肥胖组的基础内分泌水平低于正常组(P<0.05)。肥胖组基础卵泡刺激素(follicle-stimulating hormone,FSH)、基础黄体生成素(luteinizing hormone,LH)、基础雌二醇(estradiol,E2)、基础孕酮(progesterone,P)、抗缪勒管激素(anti-mullerian hormone,AMH)均低于正常体重组(P<0.05),肥胖组基础窦卵泡数(antral follicle counting,AFC)减少(P=0.011)。超重组仅表现为E2、P水平降低(P<0.05)。在助孕过程中,肥胖组促性腺激素(gonadotropin,Gn)用量最多,超重组次之,低体重组最少(P<0.001)。肥胖组的Gn天数延长(P<0.001)。超重、肥胖组扳机日LH、E2、P均低于正常体重组(P<0.05)。比较胚胎发育过程得出,肥胖组囊胚在原核消失(time of pronuclei disappearance,tPNf)、四细胞(time of four cells,t4)及囊胚形成(time of full blastocyst,tB)阶段均出现发育延迟(P<0.05)。肥胖组助孕结局较差,表现为临床妊娠率(P=0.044)及活产率(P=0.036)降低。行二分类Logistic回归分析后发现,肥胖是临床妊娠(OR=0.683,95%CI:0.479-0.973,P=0.035)及活产(OR=0.662,95%CI:0.459-0.954,P=0.027)的危险因素。年龄为生化妊娠、临床妊娠和活产的危险因素(P<0.05)。结论:女性肥胖延长不孕时间,引起内分泌紊乱,增加Gn用量及天数。女性肥胖能延迟囊胚发育过程,为临床妊娠及活产的危险因素。
基金Hainan Provincial Science and Technology Plan(Clinical Medical Research Center)Project(No.LCYX202102)。
文摘Objective:To investigate the effects of female body mass index on embryo development and assisted reproductive technology outcomes,aiming to provide better treatment for patients with different body mass index and provide reference for clinical treatment.Methods:The study retrospectively collected data of 3783 patients who received their first fresh embryo transfer and were ovulated by a long protocol at the Reproductive Medicine Center of the First Affiliated Hospital of Hainan Medical University from January 2015 to October 2021.Patients were divided into four groups based on body mass index(BMI):low weight group,normal weight group,overweight group and obese group.The normal weight group was used as a control to compare the basic information,assisted reproductive technology process,embryo development and assisted reproductive technology outcomes between different groups.Results:Analyzing patients'basic information,we found that the duration of infertility was significantly longer in obese women(P=0.007).Basal hormone levels in the overweight and obese groups were lower than those in the normal group(P<0.05).Basal Follicle-stimulating hormone(FSH),basal Luteinizing hormone(LH),basal Estradiol(E2),basal Progesterone(P),and anti-Mullerian hormone(AMH)in the obese group were lower than the normal weight group(P<0.05),and the number of antral follicle counting(AFC)was reduced in the obese group(P=0.011).The overweight group only showed a decrease in E2 and P levels(P<0.05).During the ART,there was a significant difference in Gonadotropin(Gn)dosage among the four groups,with the obese group was the most,followed by the overweight group,and the low weight group was the least(P<0.001).Gn days were increased in the obese group(P<0.001).LH,E2,and P on trigger day were all lower in the overweight and obese groups than in the normal weight group(P<0.05).Comparing the embryo development process,we found that the blastocysts of the obese group showed delayed development at the stages of pronuclei disappearance,four-cell and blastocyst formation(P<0.05).The ART outcomes were worse in the obese group,the clinical pregnancy rate(P=0.044)and live birth rate(P=0.036)were reduced in the obese group.After logistic regression,obesity was found to be a risk factor for clinical pregnancy(OR=0.683,95%CI:0.479-0.973,P=0.035)and live birth(OR=0.662,95%CI:0.459-0.954,P=0.027).Female age was a risk factor for biochemical pregnancy,clinical pregnancy and live birth(P<0.05).Conclusion:Female obesity prolongs the duration of infertility,causes endocrine disorders,increases Gn dosage and days,and leads to poorer assisted reproductive technology outcomes.Female obesity delays the blastocyst development process and presents as a risk factor for clinical pregnancy and live birth.
文摘目的探讨多房棘球蚴不同感染时间小鼠肝组织细胞外基质蛋白1(extracellular matrix protein 1,ECM1)的表达水平以及与肝纤维化过程的相关性。方法将40只雌性C57BL/6小鼠随机分为多房棘球蚴感染组和对照组(20只/组),感染组经肝门静脉接种2000个原头节/鼠,对照组注射等量生理盐水。分别于感染后第1、6、12和24周,两组各取5只小鼠采集肝组织,切片后HE染色观察多房棘球蚴感染后小鼠肝组织病理学变化;天狼星红染色以及α-SMA染色检测小鼠肝纤维化程度;免疫组织化学染色检测肝组织中ECM1的表达水平与分布。采用Pearson相关系数法分析ECM1表达水平与肝纤维化水平的相关性。结果HE染色结果显示,多房棘球蚴感染后6周,小鼠肝组织内可见具有明显生发层结构的病灶形成,周围炎性细胞浸润明显且伴有纤维组织增生。天狼星红染色结果显示,感染组小鼠肝组织内病灶周围胶原沉积面积占比在感染后1、6、12和24周分别为(6.97±0.07)%、(10.39±0.02)%、(17.31±1.78)%和(22.24±1.07)%,均高于对照组(P<0.05);α-SMA染色结果显示,感染组肝组织病灶周围α-SMA阳性染色面积占比在感染后1、6、12和24周分别为(5.31±0.39)%、(9.97±1.3)%、(16.16±0.17)%和(19.01±0.49)%,均高于对照组(P<0.05);且随着多房棘球蚴感染小鼠时间的延长病灶周围肝纤维化程度不断加重。免疫组化检测结果显示,ECM1主要表达在病灶周围的炎性细胞带中,少量表达在肝窦;感染组ECM1阳性染色面积占比在感染后1、6、12和24周分别为(8.60±0.44)%、(13.90±0.57)%、(16.37±0.77)%和(19.50±0.50)%,均高于对照组(P<0.05)。Pearson相关性分析显示,ECM1表达水平与天狼星红阳性染色区域面积(r=0.900,P<0.01)及α-SMA阳性染色区域面积占比(r=0.941,P<0.01)均呈正相关。结论ECM1在多房棘球蚴不同感染时间小鼠肝组织的表达均较对照组升高,并与肝纤维化程度呈正相关。