SO SÁNH SỰ KHÁC BIỆT VỀ KẾT QUẢ CHU KỲ THỤ TINH TRONG ỐNG NGHIỆM CỦA CÁC NHÓM BMI Ở BỆNH NHÂN NỮ TẠI BỆNH VIỆN ĐA KHOA HỒNG NGỌC NĂM 2024

Abstract

Background: Abnormal body mass index (BMI) is suggested to affect in vitro fertilization (IVF) outcomes, but evidence from IVF centers in Vietnam remains limited. Objectives: To compare the differences in embryo quality and clinical pregnancy outcomes among different BMI groups in female patients undergoing IVF/ICSI. Subjects and methods: A cross-sectional study was conducted on 398 IVF/ICSI cycles from January 1 to October 31, 2024. Patients were divided into 4 groups according to WHO Asian BMI classification: underweight (<18.5 kg/m²), normal (18.5-22.9 kg/m²), overweight (23-24.9 kg/m²), and obese (≥25 kg/m²). The number of oocytes, fertilization rate, embryo quality (day-3 embryos, blastocysts), and clinical pregnancy outcomes (β-hCG+, gestational sac, fetal heart, biochemical pregnancy) were compared. Results: There were no significant differences in the number of retrieved oocytes, fertilization rate, day-3 embryo rate, and blastocyst formation rate among groups (p>0.05). However, the rate of good/fair quality blastocysts in the normal BMI group (81.82%) was significantly higher than in other groups (p<0.05). The BMI ≥25 group had the highest biochemical pregnancy rate (18.4%) and a 3.28 times higher risk of biochemical pregnancy (95% CI: 1.18-8.69) compared to the normal BMI group. Conclusion: BMI did not affect ovarian response and fertilization rate in controlled IVF cycles. However, normal BMI (18.5-22.9 kg/m²) yielded better blastocyst quality. Obesity (BMI ≥25) significantly increased the risk of biochemical pregnancy, suggesting adverse effects on the endometrial environment. Patients should be counseled to achieve an ideal BMI, and a blastocyst culture strategy should be applied to optimize IVF outcomes.