en تأثیر شاخص توده بدنی و سندرم تخمدان پلی کیستیک بر نتایج درمان ICSI/IVF: یک مطالعه گذشته نگر در زنان پاکستانی Short Research Reports Short Research Reports <strong><span style="font-family:b mitramso-ascii-font-family:arial;"><span style="font-size:11.0pt;">مقدمه: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">چاقی ممکن است مانع جدی برای درمان باروری مفید در زنان مبتلا به سندرم تخمدان پلی&shy;کیستیک (</span></span><span dir="LTR">PCOS</span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">) باشد.</span></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">هدف: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">هدف ما مقایسه نتایج تزریق اسپرم داخل سیتوپلاسمی در زنان مبتلا به سندرم تخمدان پلی</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">کیستیک و بدون آن و ارزیابی اثر چاقی در زنان </span></span><span dir="LTR"><span style="font-size:10.0pt;">PCOS</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">.</span></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">موارد و روش&shy;ها:</span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> این مطالعه گذشته</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نگر از ژوئن 2015 تا سال 2016 انجام شد شامل زنان با و بدون </span></span><span dir="LTR"><span style="font-size:10.0pt;">PCOS</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">(طبق معیار روتردام) بود که تحت تزریق اسپرم در داخل سیتوپلاسم قرار گرفتند. </span></span><span dir="LTR"><span style="font-size:10.0pt;">PCOS</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">به غیر</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">چاق و چاق بر اساس معیارهای جنوب آسیا برای شاخص توده بدن طبقه</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">بندی شد. نتایج بر اساس گنادوتروپین کوریونیک (</span></span><span dir="LTR"><span style="font-size:10.0pt;">&beta;-hCG</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">) و </span></span><span dir="LTR"><span style="font-size:10.0pt;">transvaginal scan</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> به غیر</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">باردار (</span></span><span dir="LTR"><span style="font-size:10.0pt;">mIU/ml</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> 25</span></span><span dir="LTR"><span style="font-size:10.0pt;">&beta;-hCG</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;"><</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">)، سقط پیش بالینی (</span></span><span dir="LTR"><span style="font-size:10.0pt;">mIU/ml</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> 25</span></span><span dir="LTR"><span style="font-size:10.0pt;">&beta;-hCG</span></span><span dir="LTR"><span style="font-size:11.0pt;">></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> بدون جنین فعالیت قلبی) و حاملگی بالینی (</span></span><span dir="LTR"><span style="font-size:10.0pt;">mIU/ml</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> 25</span></span><span dir="LTR"><span style="font-size:10.0pt;">&beta;-hCG</span></span><span dir="LTR"><span style="font-size:11.0pt;">></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> با فعالیت قلبی جنین در اسکن </span></span><span dir="LTR"><span style="font-size:10.0pt;">Transvaginal</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">) مشخص شد. علاوه بر این، نتایج باروری، میزان لقاح، میزان بارداری بالینی و میزان سقط جنین در میان بیماران مبتلا به </span></span><span dir="LTR"><span style="font-size:10.0pt;">PCOS</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">چاق و غیر&shy;چاق مقایسه شد.</span></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتایج: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتایج ما نشان داد 38/5% موارد حاملگی بالینی در زنان غیر </span></span><span dir="LTR"><span style="font-size:10.0pt;">PCO</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">، 8/23% در زنان </span></span><span dir="LTR"><span style="font-size:10.0pt;">PCOS</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">غیر</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">چاق و 26/4% در زنان </span></span><span dir="LTR"><span style="font-size:10.0pt;">PCOS</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">چاق است. سقط</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">های جنین پیش</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">بالینی در خانم</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">های </span></span><span dir="LTR"><span style="font-size:10.0pt;">PCOS</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">غیر</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">چاق بیشترین میزان (31/5%) را نشان می</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">دهد و در زنان غیر </span></span><span dir="LTR"><span style="font-size:10.0pt;">PCOS</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">کمترین (26/2%) میزان بود. در گروه غیر </span></span><span dir="LTR"><span style="font-size:10.0pt;">PCOS</span></span>&nbsp; <span style="font-family:b mitra;"><span style="font-size:11.0pt;">35/4% و زنان مبتلا به </span></span><span dir="LTR"><span style="font-size:10.0pt;">PCOS</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">غیر</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">چاق 64</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">/</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">44% حامله نشدند.</span></span><br> <strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتیجه&shy; گیری: </span></span></strong><span style="font-family:b mitra;"><span style="font-size:11.0pt;">موفقیت پس از تزریق اسپرم داخل سیتوپلاسمی از نظر تعداد حاملگی</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">های بالینی در بیماران غیر </span></span><span dir="LTR"><span style="font-size:10.0pt;">PCOS</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">نسبت به </span></span><span dir="LTR"><span style="font-size:10.0pt;">PCOS</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">بیشتر بود. افزایش شاخص توده بدنی منعکس</span></span><span dir="LTR"><span style="font-family:arial,sans-serif;"><span style="font-size:11.0pt;">&shy;</span></span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">کننده تاثیر منفی بر نتایج باروری در بیماران </span></span><span dir="LTR"><span style="font-size:10.0pt;">PCOS</span></span> <span style="font-family:b mitra;"><span style="font-size:11.0pt;">است.</span></span> <strong>Background:</strong> Obesity may establish a crucial barrier for effective fertility treatment in polycystic ovary syndrome (PCOS) females.<br> <strong>Objective:</strong> To compare results of intra-cytoplasmic sperm injection (ICSI) in females with and without polycystic ovarian syndrome and further appraise the effect of obesity in PCOS females.<br> <strong>Materials and Methods:</strong> A cross-sectional study from June 2015 to July 2016 included non-PCOS and PCOS (recognized by Rotterdam criteria) females who underwent ICSI. The PCOS were further stratified into non-obese and Obese according to the South Asian criteria for body mass index. Results were categorized on the basis of beta-human chorionic gonadotropin (&beta;-hCG) and transvaginal scan into non-pregnant (&beta;-hCG <25 mIU/ml), preclinical abortion (&beta;-hCG >25 mIU/ml with no fetal cardiac activity) and clinical pregnancy (&beta;-hCG >25 mIU/ml with fetal cardiac activity on transvaginal scan). In addition, reproductive outcomes; implantation rate, clinical pregnancy rate and miscarriage rate among obese and non-obese PCOS and non-PCOS patients were compared.<br> <strong>Results:</strong> Our results revealed 38.5% clinical pregnancy rate in non-PCOs females, 23.8% in non-obese PCOS females whereas 26.4% in obese PCOS. Preclinical abortions were found to be highest (31.5%) in non-obese PCOS females and were the lowest (26.2%) in non-PCOS females. In non-PCOS group and non-obese PCOS females 35.4% and 44.6%, respectively, failed to become pregnant.<br> <strong>Conclusion:</strong> The success after ICSI in terms of number of clinical pregnancies was more in non-PCOS patients as compared to PCOS. Increase in body mass index reflected a negative impact on the reproductive outcome in PCOS patients. شاخص Quetelet, چاقی, سندرم تخمدان پلی کیستیک, تزریق اسپرم, Intracytoplasmic, ناباروری. Quetelet’s index, Obesity, Polycystic ovary syndrome, Sperm injection, Intracytoplasmic, Infertility 529 534 http://ijrm.ir/browse.php?a_code=A-10-549-149&slc_lang=en&sid=1 Rehana Rehman faiza.orakzai@gmail.com 0000-0001-9730-5553 No Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan Mohsin Mehmood faiza.orakzai@gmail.com 0000-0003-1264-7605 No Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan Rabiya Ali faiza.orakzai@gmail.com 0000-0002-2329-3059 No Department of Physiology, Bahria University Medical and Dental College, Bahria University medical and Dental college (BUMDC), Karachi campus, Defense Phase II, adjacent PNS Shifa Hospital Saeeda Shaharyar faiza.orakzai@gmail.com 0000-0003-0644-8343 No Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan Faiza Alam faiza.orakzai@gmail.com 0000-0002-4131-129X Yes Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan