摘要 : 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 referenc... 展开 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. 收起