O ?ndice de massa corporal e os desfechos da fertiliza??o in vitro
Ano de defesa: | 2021 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Pontif?cia Universidade Cat?lica do Rio Grande do Sul
|
Programa de Pós-Graduação: |
Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de
|
Departamento: |
Escola de Medicina
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://tede2.pucrs.br/tede2/handle/tede/9663 |
Resumo: | Introduction: Overweight is a risk factor for fertility mainly due to ovulation disorders; However, data about its impact on assisted reproduction techniques outcomes remain conflicting. Despite the well-established obesity risk factor for adverse perinatal outcomes in spontaneous pregnancies, there are still no studies evaluating this effect in pregnancies resulting from ART. Thus, the main objective of this study was to evaluate the association between high BMI with the laboratorial and clinical outcomes of patients undergoing ART. Methods: Retrospective cohort study, with data collection from electronic medical records of patients from a reproductive medicine center in Porto Alegre, Brazil, between 2013-2020. Patients' cycles were divided into three groups according to BMI (kg/m?): Group 1 < 25; Group 2 25-29.9 and Group 3 ?30. Quantitative variables were compared in median (IIQ) and categorical as percentage. Generalized estimating equations (GEE) were applied to consider patients and follicle-aspiration cycles, and also ANOVA and Chi-square tests, multiple logistic regression and post-hoc curve were applied according to the variables analyzed. It was considered statistically significant p <0.05. The sample size was enough for a 12% power. Results: A significant linear tendency to a higher proportion of cancelled IVF cycles as higher as was the BMI was observed (6.9% vs 7.8% vs 10.4%, p= 0.002). We also found a higher gonadotropin's total dose in groups 2 and 3 (1685?595 vs. 1779?610 vs. 1805?563 p=0.001). A greater number of mature oocytes was observed in Group 1 and 2 (6 [6.4-7] vs 6 [5.6-6.6] vs 4 [4.6-6.7], p= 0.0111), but no difference between oocyte mature rate. Lower but not statistically significant implantation (%) (28.4 vs 27.5 vs 23.2, p = 0.187), clinical pregnancy (%) (40.1 vs 39.7 vs 32.5, p= 0.262) and live birth rates (%) (33.5 vs 32.3 vs 29.9, p = 0.668) was found in groups 2 and 3. We also observed that the higher the BMI, the worse was the cumulative clinical pregnancy rate, with significant linear tendency (p=0.042). Perinatal outcomes were similar between groups (maternal and newborn conditions). Conclusion: Overweight and obesity were associated with higher cancelation rates, higher gonadotropine doses and lower, but not statistically different chances of implantation, clinical pregnancy and live birth rates. |
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Padoin, Alexandre Vontobelhttp://lattes.cnpq.br/0241056171343649Costa, Bartira Erc?lia Pinheiro dahttp://lattes.cnpq.br/3553707735604418http://lattes.cnpq.br/5352813604467538Dornelles, Vict?ria Campos2021-05-27T11:27:43Z2021-03-26http://tede2.pucrs.br/tede2/handle/tede/9663Introduction: Overweight is a risk factor for fertility mainly due to ovulation disorders; However, data about its impact on assisted reproduction techniques outcomes remain conflicting. Despite the well-established obesity risk factor for adverse perinatal outcomes in spontaneous pregnancies, there are still no studies evaluating this effect in pregnancies resulting from ART. Thus, the main objective of this study was to evaluate the association between high BMI with the laboratorial and clinical outcomes of patients undergoing ART. Methods: Retrospective cohort study, with data collection from electronic medical records of patients from a reproductive medicine center in Porto Alegre, Brazil, between 2013-2020. Patients' cycles were divided into three groups according to BMI (kg/m?): Group 1 < 25; Group 2 25-29.9 and Group 3 ?30. Quantitative variables were compared in median (IIQ) and categorical as percentage. Generalized estimating equations (GEE) were applied to consider patients and follicle-aspiration cycles, and also ANOVA and Chi-square tests, multiple logistic regression and post-hoc curve were applied according to the variables analyzed. It was considered statistically significant p <0.05. The sample size was enough for a 12% power. Results: A significant linear tendency to a higher proportion of cancelled IVF cycles as higher as was the BMI was observed (6.9% vs 7.8% vs 10.4%, p= 0.002). We also found a higher gonadotropin's total dose in groups 2 and 3 (1685?595 vs. 1779?610 vs. 1805?563 p=0.001). A greater number of mature oocytes was observed in Group 1 and 2 (6 [6.4-7] vs 6 [5.6-6.6] vs 4 [4.6-6.7], p= 0.0111), but no difference between oocyte mature rate. Lower but not statistically significant implantation (%) (28.4 vs 27.5 vs 23.2, p = 0.187), clinical pregnancy (%) (40.1 vs 39.7 vs 32.5, p= 0.262) and live birth rates (%) (33.5 vs 32.3 vs 29.9, p = 0.668) was found in groups 2 and 3. We also observed that the higher the BMI, the worse was the cumulative clinical pregnancy rate, with significant linear tendency (p=0.042). Perinatal outcomes were similar between groups (maternal and newborn conditions). Conclusion: Overweight and obesity were associated with higher cancelation rates, higher gonadotropine doses and lower, but not statistically different chances of implantation, clinical pregnancy and live birth rates.Introdu??o: O excesso de peso ? fator de risco ? infertilidade devido, principalmente, aos dist?rbios de ovula??o; todavia, os dados sobre esse impacto nos desfechos das t?cnicas de reprodu??o assistida (TRA) permanecem conflitantes. Apesar do bem estabelecido fator de risco da obesidade a desfechos perinatais adversos de gesta??es espont?neas, ainda n?o existem estudos avaliando esse efeito em gesta??es resultantes de TRA. Com isso, o principal objetivo deste estudo foi avaliar a associa??o entre o IMC elevado e os desfechos laboratoriais e cl?nicos em pacientes submetidos ?s TRA. M?todos: Estudo de coorte retrospectiva, com coleta de dados a partir de prontu?rios eletr?nicos de pacientes de um centro de medicina reprodutiva em Porto Alegre, Brasil, entre 2013-2020. Os ciclos das pacientes foram divididos em tr?s grupos de acordo com o IMC (kg/m?): Grupo 1 < 25; Grupo 2 25-29.9 e Grupo 3 ?30. As vari?veis quantitativas foram comparadas em mediana (IIQ) e categ?ricas em porcentagem. Generalized estimating equations (GEE) foi aplicado para considerar pacientes e ciclos de fol?culo aspira??o, realizando tamb?m os testes ANOVA e Qui-quadrado, regress?o m?ltipla log?stica e curva post-hoc conforme as vari?veis analisadas. Foi considerado estatisticamente significativo p<0,05. O tamanho amostral foi suficiente para um poder de 12%. Resultados: Foi observada maior propor??o de ciclos de FIV cancelados quanto maior o IMC (6.9% vs 7.8% vs 10.4%, p= 0.002) e uma maior dose de gonadotrofina necess?ria para pacientes nos grupos 2 e 3 (1685?595 vs. 1779?610 vs. 1805?563 p=0.001). Um maior n?mero de o?citos maduros foi observado nos grupos 1 e 2 (6 [6.4-7] vs 6 [5.6-6.6] vs 4 [4.6-6.7], p= 0.0111), mas n?o houve diferen?a na taxa de o?citos maduros. Foram observadas menores, ainda que n?o significativas, taxas de implanta??o (%) (28.4 vs 27.5 vs 23.2, p = 0.187), gravidez cl?nica (%) (40.1 vs 39.7 vs 32.5, p= 0.262) e de nascidos vivos (%) (33.5 vs 32.3 vs 29.9, p = 0.668) nos grupos 2 e 3. Quanto maior o IMC, pior foi a taxa de gravidez cl?nica cumulativa, com uma tend?ncia linear significativa (p=0.042). Os desfechos perinatais foram semelhantes entre os grupos (maternos e neonatais). Conclus?o: Sobrepeso e obesidade foram associados com maior taxas de ciclos cancelados, maiores doses de gonadotrofinas e menor, embora n?o significativa, chance de implanta??o, gravidez cl?nica e nascidos vivos.Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2021-05-03T17:18:48Z No. of bitstreams: 1 DISSERTAC?A?O VICTORIA DORNELLES 2021.pdf: 1307913 bytes, checksum: 243ed04655873aaf9306baaced5daabb (MD5)Rejected by Caroline Xavier (caroline.xavier@pucrs.br), reason: Devolvido devido a falta de capa institucional. on 2021-05-17T17:10:42Z (GMT)Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2021-05-24T21:16:56Z No. of bitstreams: 1 VICTO?RIA CAMPOS DORNELLES.pdf: 1718143 bytes, checksum: 4ada9181f8a27c493759d4fcaee9df08 (MD5)Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2021-05-27T11:16:25Z (GMT) No. of bitstreams: 1 VICTO?RIA CAMPOS DORNELLES.pdf: 1718143 bytes, checksum: 4ada9181f8a27c493759d4fcaee9df08 (MD5)Made available in DSpace on 2021-05-27T11:27:43Z (GMT). No. of bitstreams: 1 VICTO?RIA CAMPOS DORNELLES.pdf: 1718143 bytes, checksum: 4ada9181f8a27c493759d4fcaee9df08 (MD5) Previous issue date: 2021-03-26Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPqapplication/pdfhttp://tede2.pucrs.br:80/tede2/retrieve/180988/DIS_VICTORIA_CAMPOS_DORNELLES_CONFIDENCIAL.pdf.jpgporPontif?cia Universidade Cat?lica do Rio Grande do SulPrograma de P?s-Gradua??o em Medicina e Ci?ncias da Sa?dePUCRSBrasilEscola de MedicinaSobrepesoObesidadeInfertilidadeT?cnicas de Reprodu??o AssistidaOverweightObesityInfertilityAssisted Reproductive TechniquesCIENCIAS DA SAUDE::MEDICINAO ?ndice de massa corporal e os desfechos da fertiliza??o in vitroinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisTrabalho ser? publicado como artigo ou livro60 meses27/05/2026-721401722658532398500500500600-224747486637135387-9693694523087866271802873727776104890info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSTHUMBNAILDIS_VICTORIA_CAMPOS_DORNELLES_CONFIDENCIAL.pdf.jpgDIS_VICTORIA_CAMPOS_DORNELLES_CONFIDENCIAL.pdf.jpgimage/jpeg4073http://tede2.pucrs.br/tede2/bitstream/tede/9663/6/DIS_VICTORIA_CAMPOS_DORNELLES_CONFIDENCIAL.pdf.jpg28fd5886b74e800b4cb1d5965bd59a17MD56TEXTDIS_VICTORIA_CAMPOS_DORNELLES_CONFIDENCIAL.pdf.txtDIS_VICTORIA_CAMPOS_DORNELLES_CONFIDENCIAL.pdf.txttext/plain1712http://tede2.pucrs.br/tede2/bitstream/tede/9663/5/DIS_VICTORIA_CAMPOS_DORNELLES_CONFIDENCIAL.pdf.txt828ad85910c127b515ad2fc2ca760c06MD55ORIGINALDIS_VICTORIA_CAMPOS_DORNELLES_CONFIDENCIAL.pdfDIS_VICTORIA_CAMPOS_DORNELLES_CONFIDENCIAL.pdfapplication/pdf389014http://tede2.pucrs.br/tede2/bitstream/tede/9663/4/DIS_VICTORIA_CAMPOS_DORNELLES_CONFIDENCIAL.pdf09d75cf1fd776d52637d018e3fdd05c7MD54LICENSElicense.txtlicense.txttext/plain; charset=utf-8590http://tede2.pucrs.br/tede2/bitstream/tede/9663/3/license.txt220e11f2d3ba5354f917c7035aadef24MD53tede/96632021-05-28 20:00:19.459oai:tede2.pucrs.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2021-05-28T23:00:19Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
O ?ndice de massa corporal e os desfechos da fertiliza??o in vitro |
title |
O ?ndice de massa corporal e os desfechos da fertiliza??o in vitro |
spellingShingle |
O ?ndice de massa corporal e os desfechos da fertiliza??o in vitro Dornelles, Vict?ria Campos Sobrepeso Obesidade Infertilidade T?cnicas de Reprodu??o Assistida Overweight Obesity Infertility Assisted Reproductive Techniques CIENCIAS DA SAUDE::MEDICINA |
title_short |
O ?ndice de massa corporal e os desfechos da fertiliza??o in vitro |
title_full |
O ?ndice de massa corporal e os desfechos da fertiliza??o in vitro |
title_fullStr |
O ?ndice de massa corporal e os desfechos da fertiliza??o in vitro |
title_full_unstemmed |
O ?ndice de massa corporal e os desfechos da fertiliza??o in vitro |
title_sort |
O ?ndice de massa corporal e os desfechos da fertiliza??o in vitro |
author |
Dornelles, Vict?ria Campos |
author_facet |
Dornelles, Vict?ria Campos |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Padoin, Alexandre Vontobel |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/0241056171343649 |
dc.contributor.advisor-co1.fl_str_mv |
Costa, Bartira Erc?lia Pinheiro da |
dc.contributor.advisor-co1Lattes.fl_str_mv |
http://lattes.cnpq.br/3553707735604418 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/5352813604467538 |
dc.contributor.author.fl_str_mv |
Dornelles, Vict?ria Campos |
contributor_str_mv |
Padoin, Alexandre Vontobel Costa, Bartira Erc?lia Pinheiro da |
dc.subject.por.fl_str_mv |
Sobrepeso Obesidade Infertilidade T?cnicas de Reprodu??o Assistida |
topic |
Sobrepeso Obesidade Infertilidade T?cnicas de Reprodu??o Assistida Overweight Obesity Infertility Assisted Reproductive Techniques CIENCIAS DA SAUDE::MEDICINA |
dc.subject.eng.fl_str_mv |
Overweight Obesity Infertility Assisted Reproductive Techniques |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
Introduction: Overweight is a risk factor for fertility mainly due to ovulation disorders; However, data about its impact on assisted reproduction techniques outcomes remain conflicting. Despite the well-established obesity risk factor for adverse perinatal outcomes in spontaneous pregnancies, there are still no studies evaluating this effect in pregnancies resulting from ART. Thus, the main objective of this study was to evaluate the association between high BMI with the laboratorial and clinical outcomes of patients undergoing ART. Methods: Retrospective cohort study, with data collection from electronic medical records of patients from a reproductive medicine center in Porto Alegre, Brazil, between 2013-2020. Patients' cycles were divided into three groups according to BMI (kg/m?): Group 1 < 25; Group 2 25-29.9 and Group 3 ?30. Quantitative variables were compared in median (IIQ) and categorical as percentage. Generalized estimating equations (GEE) were applied to consider patients and follicle-aspiration cycles, and also ANOVA and Chi-square tests, multiple logistic regression and post-hoc curve were applied according to the variables analyzed. It was considered statistically significant p <0.05. The sample size was enough for a 12% power. Results: A significant linear tendency to a higher proportion of cancelled IVF cycles as higher as was the BMI was observed (6.9% vs 7.8% vs 10.4%, p= 0.002). We also found a higher gonadotropin's total dose in groups 2 and 3 (1685?595 vs. 1779?610 vs. 1805?563 p=0.001). A greater number of mature oocytes was observed in Group 1 and 2 (6 [6.4-7] vs 6 [5.6-6.6] vs 4 [4.6-6.7], p= 0.0111), but no difference between oocyte mature rate. Lower but not statistically significant implantation (%) (28.4 vs 27.5 vs 23.2, p = 0.187), clinical pregnancy (%) (40.1 vs 39.7 vs 32.5, p= 0.262) and live birth rates (%) (33.5 vs 32.3 vs 29.9, p = 0.668) was found in groups 2 and 3. We also observed that the higher the BMI, the worse was the cumulative clinical pregnancy rate, with significant linear tendency (p=0.042). Perinatal outcomes were similar between groups (maternal and newborn conditions). Conclusion: Overweight and obesity were associated with higher cancelation rates, higher gonadotropine doses and lower, but not statistically different chances of implantation, clinical pregnancy and live birth rates. |
publishDate |
2021 |
dc.date.accessioned.fl_str_mv |
2021-05-27T11:27:43Z |
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2021-03-26 |
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