OBJECTIVE:To evaluate the effects of low body mass index (BMI) on in vitro fertilization (IVF) outcomes in fresh transfer cycles. DESIGN:Retrospective cohort study. SETTING:University-affiliated hospital. PATIENT(S):A total of 4,798 cycles with conventional stimulation and fresh transfer in a single IVF center during the period 2013-2014. Low BMI (<18.5 kg/m2) was defined according to World Health Organization guidelines, and cycles within a normal weight range (18.5-24.9 kg/m2) were used as reference. INTERVENTION(S):None. MAIN OUTCOME MEASURE(S):Live birth rate per fresh embryo transfer. RESULT(S):Low BMI was associated with reduced live birth rates and increased miscarriage rates compared with normal weight, controlling for important covariates known to influence IVF outcomes. Patient age was the most potent confounder, causing a 10.5% reduction in the odds ratio (OR) for live birth between the groups compared. When an interaction term (age × BMI) was introduced, the OR for live birth was reduced in cycles of those aged ≥35 years compared with cycles of those aged 28-34 years, whereas the change in OR between cycles in those aged <28 and cycles in those aged 28-34 years was insignificant. CONCLUSION(S):Low BMI is associated with negative outcomes in fresh transfer cycles, especially for women of advanced age.

译文

目的:评估低体重指数(BMI)对新鲜转移周期中体外受精(IVF)结果的影响。
设计:回顾性队列研究。
单位:大学附属医院。
患者:2013-2014年期间,单个IVF中心总共进行了4,798个周期的常规刺激和新鲜转移。根据世界卫生组织的指南定义了低BMI(<18.5 kg / m2),并以正常体重范围(18.5-24.9 kg / m2)内的周期为参考。
干预措施:无。
主要观察指标:每次新鲜胚胎移植的活产率。
结果:与正常体重相比,低BMI与活产率降低和流产率增加有关,控制了已知影响IVF结果的重要协变量。患者年龄是最有力的混杂因素,导致两组之间活产的比值比(OR)降低10.5%。引入交互作用项(年龄×BMI)时,≥35岁的人的活产儿的OR值比28-34岁的人的活产儿的OR值降低,而<28岁的人的活产儿的OR值变化并且年龄在28-34岁之间的周期微不足道。
结论:低BMI与新鲜转移周期的负结果有关,尤其是对于高龄女性。

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