en اثر وزن بر روی نتایج حاملگی در تزریق داخل سیتوپلاسمی اسپرم Original Article Original Article <strong><span style="font-family:b mitra;">مقدمه: </span></strong><span style="font-family:b mitra;">یک افزایش در تعداد زنان نابارور چاق جهت درمان ناباروری مانند </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">IVF</span></span></span><span style="font-family:b mitra;"> و </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">ICSI</span></span></span><span style="font-family:b mitra;"> وجود دارد. آگاهی در مورد اثر </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">BMI</span></span></span><span style="font-family:b mitra;"> روی نتایج باروری می&shy;تواند در مواجهه با این بیماران کمک&shy;کننده باشد.</span><br> <strong><span style="font-family:b mitra;">هدف:</span></strong><span style="font-family:b mitra;"> هدف از انجام این مطالعه مقایسه نتایج باروری در زنان با </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">BMI</span></span></span><span style="font-family:b mitra;"> متفاوت بعد از </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">ICSI</span></span></span><span style="font-family:b mitra;"> بود. </span><span dir="LTR"></span><br> <strong><span style="font-family:b mitra;">مواد و روش&shy;ها: </span></strong><span style="font-family:b mitra;">مطالعه به روش </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">Quasi</span></span></span> <span style="font-family:b mitra;">بر روی 323 زن بین ژوئن 2010 تا آگوست 2011 انجام شد. زنان بر اساس </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">BMI</span></span></span><span style="font-family:b mitra;"> به گروه&shy;های زیر وزن&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;(</span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">kg/m²</span></span></span><span style="font-family:b mitra;"> 18></span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">BMI</span></span></span><span style="font-family:b mitra;">)، وزن نرمال (</span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">kg/m²</span></span></span><span style="font-family:b mitra;"> 18-22/9=&nbsp;</span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">BMI</span></span></span><span style="font-family:b mitra;">)، افزایش وزن (</span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">kg/m²</span></span></span><span style="font-family:b mitra;"> 23-25/9=&nbsp;</span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">BMI</span></span></span><span style="font-family:b mitra;">) و چاق (</span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">kg/m²</span></span></span><span style="font-family:b mitra;"> 26</span><span style="font-family:times new roman,serif;">&le;</span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">BMI</span></span></span><span style="font-family:b mitra;">) تقسیم شدند. درمان شامل </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">down regulation</span></span></span><span style="font-family:b mitra;"> تخمدان&shy;ها، تحریک کنترل شده تخمدان&shy;ها، ترویج تخمک&shy;گذاری با </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">hCG</span></span></span><span style="font-family:b mitra;">، برداشتن تخمک، </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">IVF</span></span></span><span style="font-family:b mitra;"> و ترانسفر جنین بود. وضعیت &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;اووسیت و امبریو در تمام گروه&shy;های </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">BMI</span></span></span><span style="font-family:b mitra;"> با تست </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">ANOVA</span></span></span><span style="font-family:b mitra;"> مقایسه شد. نتایج حاملگی شامل: عدم حاملگی با </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">IU/ml</span></span></span><span style="font-family:b mitra;"> 5></span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">&beta;hCG</span></span></span><span style="font-family:b mitra;">، حاملگی پره کلینیکال و سقط با </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">IU/ml</span></span></span><span style="font-family:b mitra;"> 5<</span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">&beta;hCG</span></span></span><span style="font-family:b mitra;"> و عدم فعالیت قبلی در روند حاملگی کلینیکال با </span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">IU/ml</span></span></span><span style="font-family:b mitra;"> 5<</span><span dir="LTR"><span style="font-family:times new roman,serif;"><span style="font-size:10.0pt;">&beta;hCG</span></span></span><span style="font-family:b mitra;"> و فعالیت قبلی در روند بود.</span><span style="font-family:b nazanin;"><span style="font-size:12.0pt;"></span></span><br> <strong><span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتایج:&nbsp;</span></span></span></strong><span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;">خانم&shy;های با BMI 23-25/9kg/m^2&nbsp;دارای تعداد حداکثر اووسیت&shy;های به&shy;دست آمده، لقاح، لانه&shy;گزینی و حاملگی کلینیکال در مقایسه با خانم&shy;های &rlm;</span><span style="font-size:14px;">kg/m²</span><span style="font-size: 11pt;">&nbsp;26</span></span><span style="font-family:times new roman,serif;"><span style="font-size:11.0pt;">&le;</span></span><span style="font-family:b mitra;"><span style="font-size:11.0pt;">BMI بودند.</span></span></span><br> <strong><span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;">نتیجه&shy;گیری:</span></span></span></strong><span dir="RTL"><span style="font-family:b mitra;"><span style="font-size:11.0pt;"> میزان cut off&nbsp;بر روی BMI&nbsp;در حدود 26 می&shy;باشد که در ارتباط با اثرات منفی بر روی نتایج حاملگی است.&nbsp;</span></span></span> <strong>Background: </strong>There has been an increase in number of obese infertile females booked for advanced infertility treatment procedures like in vitro fertilization (IVF) and intra cytoplasmic sperm injection (ICSI). The knowledge of impact of body mass index (BMI) on reproductive outcome can help to counsel these patients.<br> <strong>Objective:</strong> To compare reproductive outcome in females of different BMI after ICSI.<br> <strong>Materials and Methods:</strong> Cross-sectional study of 323 females was conducted from June 2010 till August 2011. Females were grouped on the basis of BMI; underweight, (BMI <18 kg/m2), normal weight, (BMI 18-22.9 kg/m2) overweight (BMI 23-25.9 kg/m2) and obese (BMI &ge;26 kg/m2). The procedure involved down regulation of ovaries, controlled ovarian stimulation, ovulation induction by hCG, oocyte pickup, in vitro fertilization and embryo transfer of blastocysts. The oocyte yield and embryological data of all BMI groups was compared by ANOVA (analysis of variance). Pregnancy outcome of these was categorized as; no conception &beta;hCG <5 m IU/ml, preclinical abortion with &beta;hCG >5 m IU/ml, no cardiac activity on trans vaginal scan (TVS) and clinical pregnancy with &beta;hCG >5mIU/ml and cardiac activity on trans vaginal scan.<br> <strong>Results:</strong> Females with BMI 23-25.99 kg/m2 had maximum oocyte retrieval, fertilization, implantation and clinical pregnancy rates in comparison to obese females with BMI &ge;26 kg/m2.<br> <strong>Conclusion:</strong> A BMI cut off value of above 26 kg/m2 in our study population is associated with a negative impact on pregnancy outcome. تزریق داخل سیتوپلاسمی اسپرم, شاخص توده بدنی, تحریک کنترل شده تخمدان, هورمون های آزادکننده گنادوتروپین آگونیست, انتقال جنین. Intracytoplasmic sperm injection, Body mass index, Controlled ovarian stimulation, Gonadotrophin -releasing hormone agonists, Embryo transfer. 717 0 http://ijrm.ir/browse.php?a_code=A-10-1-526&slc_lang=en&sid=1 Rehana Rehman No Department of Physiology, Bahria University Medical and Dental College, Karachi, Pakistan Zahir Hussain zahussai@yahoo.ca Yes Department of Physiology, Umm Al-Qura University, Makkah, Kingdom Saudia Arabia Syeda Sadia Fatima No Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan