夫妻双方胰岛素抵抗对体外受精-胚胎移植治疗结局的影响

雷若冰; 李维宏

doi:10.16016/j.2097-0927.202311072

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夫妻双方胰岛素抵抗对体外受精-胚胎移植治疗结局的影响

临床医学 | 更新时间：2026-01-09

- 夫妻双方胰岛素抵抗对体外受精-胚胎移植治疗结局的影响
- Effect of insulin resistance in couples on IVF-ET treatment outcomes
- 陆军军医大学学报 2024年46卷第6期页码：623-629
- 作者机构：
  
  400016 重庆，重庆医科大学附属第一医院生殖医学中心
- 作者简介：
  
  [李维宏，E-mail：liweihong1211@163.comLI Weihong, E-mail: liweihong1211@163.com
- 基金信息：
  
  国家自然科学基金(81501335);重庆市自然科学基金(CSTB2022NSCQ-MSX0086)
- DOI：10.16016/j.2097-0927.202311072
  中图分类号： R181.32;R587.1;R711.6
- 收稿：2023-11-15，
  
  修回：2023-12-13，
  
  纸质出版：2024-03-30
- 稿件说明：
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雷若冰, 李维宏. 夫妻双方胰岛素抵抗对体外受精-胚胎移植治疗结局的影响[J]. 陆军军医大学学报, 2024,46(6):623-629.

Ruobing LEI, Weihong LI. Effect of insulin resistance in couples on IVF-ET treatment outcomes[J]. Journal of Army Medical University, 2024, 46(6): 623-629.
雷若冰, 李维宏. 夫妻双方胰岛素抵抗对体外受精-胚胎移植治疗结局的影响[J]. 陆军军医大学学报, 2024,46(6):623-629. DOI： 10.16016/j.2097-0927.202311072.

Ruobing LEI, Weihong LI. Effect of insulin resistance in couples on IVF-ET treatment outcomes[J]. Journal of Army Medical University, 2024, 46(6): 623-629. DOI： 10.16016/j.2097-0927.202311072.

摘要

目的

探讨原发不孕夫妻双方胰岛素抵抗对新鲜周期胚胎移植妊娠结局的影响。

方法

纳入2022年10月-2023年10月在重庆医科大学附属第一医院生殖医学中心首次行体外受精-胚胎移植/卵泡浆内单精子显微注射(in vitro fertilization and embryo transfer/intracytoplasmic sperm injection

IVF-ET/ICSI)助孕并进行新鲜周期胚胎移植的原发不孕夫妻101例。根据患者夫妇单方是否合并胰岛素抵抗(insulin resistance

IR)，分别分为两组：女方IR组(49例)，女方无IR组(52例)。男方IR组(49例)，男方无IR组(52例)。比较女方IR组和非IR组，男方IR组和非IR，各组间基础资料、促排卵情况、胚胎移植情况和妊娠结局的差异，Logistic回归分析胰岛素抵抗对妊娠结局及促排卵实验室指标的影响。

结果

① IR女性组的体质量、BMI与非IR女性组比较均显著升高(

0.05)，AFC与非IR女性组比较显著减少(

0.05)。②女性空腹血糖与获卵数、MII卵数、可移植胚胎数、优质胚胎数均呈负相关(

0.05)；女性空腹胰岛素与GN天数及总量呈正相关(

0.05)；女性HOMA-IR与GN天数及总量呈正相关(

0.05)。③IR女性组胚胎种植率、临床妊娠率与非IR女性组相比均显著降低(

0.05)。④男性IR组的BMI与男性非IR组比较显著升高(

0.05)。⑤三组夫妻(双方IR组、一方IR组、双方均无IR组)的胚胎种植率、临床妊娠率有降低趋势，但无统计学差异。⑥女性空腹血糖显著负向影响获卵数、MII卵数、可移植胚胎数、优质胚胎数。

结论

胰岛素抵抗影响原发不孕女性IVF/ICSI周期的胚胎质量；原发不孕夫妻双方胰岛素抵抗可能对IVF/ICSI周期的胚胎种植率和临床妊娠率有负面影响。

Abstract

Objective

To investigate the effect of insulin resistance (IR) in primary infertile couples on pregnancy outcomes in fresh cycle embryo transfer.

Methods

A total of 101 primary infertile couples who underwent first IVF-ET/ICSI assisted conception with fresh cycle embryo transfer in our reproductive medical center from October 2022 to October 2023 were retrospectively included. According to whether they had combined IR unilaterally

these couples were divided into female IR group (

=49) and female non-IR group (

=52)

and male IR group (

=49) and male non-IR group (

=52). The basic data

ovulation promotion

embryo transfer and pregnancy outcome were compared between the female IR group and non-IR group

and between the male IR group and non-IR group. Logistic regression analysis was applied to determine the effect of IR on pregnancy outcome and laboratory indicators of ovulation promotion.

Results

① The IR female group had significantly higher body

weight and BMI

and lower antral follicle count (AFC) when compared with the non-IR female group (

0.05). ② Female fasting blood glucose was negatively correlated with the number of acquired eggs

number of metaphase Ⅱ (MII) oocytes

number of transferable embryos

and number of high-quality embryos (

0.05); and both female fasting insulin level and female HOMA-IR were positively correlated with the days and total amount of gonadotropin (GN) (

0.05). ③ Embryo implantation and clinical pregnancy rates were significantly lower in the female IR group than the female non-IR group (

0.05). ④ The male IR group had significantly higher BMI than the male non-IR group (

0.05). ⑤Embryo implantation rate and clinical pregnancy rate were in declining trend in all following 3 groups of couples (both IR groups

single IR group

and neither IR group). ⑥ Female fasting blood glucose level showed a negative effect on number of acquired eggs

number of MII oocytes

number of transferable embryos

and number of high-quality embryos.

Conclusion

IR affects embryo quality in IVF/ICSI cycles in women with primary infertility; IR in couples with primary infertility negatively affects embryo implantation rates and clinical pregnancy rates in IVF/ICSI cycles.

关键词

Keywords

references

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