Body Mass Index, Proteinstoffwechselprofile und Ergebnisse bei Patientinnen unter IVF-/ICSI-Behandlung
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OBJECTIVE: Higher risks of infertility have been found in overweight women. The purpose of the present study was to explore whether protein metabolism profiles related to body mass index (BMI) and to find out whether these parameters should affect IVF/ICSI outcome. PATIENTS AND METHODS: 52 patients were enrolled in this study. All patients underwent an ovarian stimulation either with recombinant follicle stimulating hormone (Gonal-F) or human menopausal gonadotropin (Menogon) after pituitary down-regulation with Goserelin (Zoladex) or Triptorelin (Decapeptyl Gyn). Five blood samples were taken: before treatment, at the beginning of ovarian stimulation, on the day of HCG injection for the ovulation induction, on the day of follicle aspiration and 14 days after embryo transfer. The blood samples were analysed with regard to the serum concentrations of total protein, albumin, total bilirubin and urea. According to the BMI values the patients were divided into two groups: BMI < 25 kg/m (2) (GI, n = 28) and BMI > 25 kg/m (2) (GII, n = 24). The results of IVF/ICSI outcome were compared in both groups. RESULTS: In both groups, the serum concentrations of total protein, albumin, total bilirubin and urea decreased during ovarian stimulation. In GII, albumin concentration decreased significantly on the day of follicle aspiration (46.0 +/- 2.3 g/l versus 43.5 +/- 2.5 g/l, p < 0.001) and 14 days after embryo transfer (46.8 +/- 2.5 g/l versus 44.7 +/- 2.3 g/l, p < 0.002), whereas the concentration of total bilirubin was not significantly decreased on the day of HCG injection (0.57 +/- 0.29 mg/dl versus 0.49 +/- 0.26 mg/dl, p = 0.11). Furthermore, pregnancy rate in women with BMI < 25 kg/m (2) was 46.4 % and in women with BMI > 25 kg/m (2) 33.1 % (p = 0.34). CONCLUSIONS: Serum concentrations of albumin and total bilirubin are influenced by BMI. Excess weight defined as BMI > 25 kg/m (2) has a negative impact on IVF outcome leading to decreased chances of pregnancy.
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