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目的:探讨不同体质量指数（body mass index，BMI）对多囊卵巢综合征（polycystic ovary syndrome，PCOS）患者体外受精-胚胎移植（n in vitro fertilization and embryo transfer，IVF-ET）临床结局的影响。n 方法:回顾性队列研究分析2016年1月至2018年12月期间在郑州大学第一附属医院生殖医学中心就诊的年龄<35岁首次行IVF-ET助孕并采用卵泡期长效长方案的患者临床资料，共2982例，其中PCOS患者（PCOS组）999例，单纯因输卵管因素不孕的患者（非PCOS组）1983例，所有患者均排除其他合并症。PCOS患者再根据BMI分为超重PCOS组（24.0 kg/mn 2≤BMI<28.0 kg/mn 2）和正常体质量PCOS组（18.5 kg/mn 2≤BMI<24.0 kg/mn 2）。计算并比较各组患者的一般资料、妊娠结局、胚胎发育指标，分析BMI对妊娠结局及胚胎发育潜能的影响，同时研究新生儿出生体质量与母体BMI的相关性。n 结果:第3日（day 3，D3）胚胎移植的正常体质量PCOS组优质胚胎率［67.41%（1906/2826）］、囊胚形成率［56.39%（578/1025）］、优质囊胚形成率［29.75%（305/1025）］及可利用胚胎率［62.14%（1756/2826）］均高于超重PCOS组［62.65%（1753/2798），n P<0.001；47.30%（457/966），n P<0.001；16.35%（158/966），n P<0.001；59.04%（1652/2798），n P=0.018］。第5日（day 5，D5）囊胚移植的正常体质量PCOS组总受精率［82.38%（1711/2077）］、双原核受精率［68.03%（1413/2077）］、囊胚形成率［68.90%（554/804）］、优质囊胚形成率［62.56%（503/804）］及可利用胚胎率［57.16%（802/1403）］均较超重PCOS组高［80.21%（2954/3683），n P=0.044；64.76%（2385/3683），n P=0.012；63.95%（871/1362），n P<0.001；30.32%（413/1362），n P<0.001；53.03%（1250/2357），n P=0.014］，种植率［66.67%（72/108）］、临床妊娠率［66.97%（73/109）］及流产率［9.59%（7/73）］均较超重PCOS组低［80.57%（141/175），n P=0.008；80.46%（140/174），n P=0.011；20.71%（29/140），n P=0.040］。logistic回归分析显示D5移植的超重PCOS患者的临床妊娠率（an OR=1.92，95% n CI=1.049~3.515，n P=0.034）及流产率（an OR=3.09，95% n CI=1.209~7.915，n P=0.019）分别为正常体质量PCOS组的1.92及3.09倍。Pearson相关性分析结果显示，D3、D5移植的PCOS患者及D3移植的非PCOS患者BMI与新生儿出生体质量均呈正相关（n r=0.144，n P=0.013；n r=0.212，n P=0.004；n r=0.137，n P<0.001）。D5移植的超重PCOS患者组新生儿出现巨大儿的概率（an OR=5.33，95% n CI=1.525~18.597，n P=0.009）为正常体质量PCOS组的5.33倍。n 结论:高BMI可能是影响PCOS患者胚胎质量及流产率增高的主要因素。超重或肥胖可能会使新生儿出生体质量增加，PCOS患者在行IVF助孕治疗前减重将有助于改善胚胎质量及新生儿出生体质量。“,”Objective:To observe the outcome of n in vitro fertilization-embryo transfer (IVF-ET) in patients with polycystic ovary syndrome (PCOS) under different body mass index (BMI).n Methods:A retrospective cohort study was performed on the clinical data of 2982 patients under 35 years old who received the first cycle with adopted long-term follicular phase plan during January 2016 to December 2018 in the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University, including 999 patients with PCOS (PCOS group) and 1983 patients with infertility due to tubal factors alone without other complications (non-PCOS group). Patients in PCOS group were divided into overweight PCOS group (24.0 kg/mn 2≤BMI<28.0 kg/mn 2) and normal weight PCOS group (18.5 kg/mn 2≤BMI<24.0 kg/mn 2). The general information, pregnancy outcome and embryo development indexes of patients in each group were calculated and compared, and the effects of BMI on pregnancy outcome and embryo development potential were analyzed. Meanwhile, the correlation between newborn birth weight and maternal BMI was studied.n Results:High-quality embryo rate [67.41% (1906/2826)], blastocyst formation rate [56.39% (578/1025)], high-quality blastocyst formation rate [29.75% (305/1025)] and available embryo rate [62.14% (1756/2826)] of normal weight PCOS group were all higher than those of overweight PCOS group [62.65% (1753/2798),n P<0.001; 47.30% (457/966),n P<0.001; 16.35% (158/966),n P<0.001; 59.04% (1652/2798),n P=0.018]. Normal weight PCOS group compared with overweight PCOS group transferred on day 5 (D5), total fertilization rate [82.38% (1711/2077)], two pronuclei (2PN) fertilization rate [68.03% (1413/2077)], blastocyst formation rate, high-quality blastocyst formation rate [68.90% (554/804)], and available embryo rate [57.16% (802/1403)] were higher in normal weight PCOS group [80.21% (2954/3683),n P=0.044; 64.76% (2385/3683), n P=0.012; 63.95% (871/1362), n P<0.001; 30.32% (413/1362),n P<0.001; 53.03% (1250/2357),n P=0.014]. The implantation rate [66.67% (72/108)], the clinical pregnancy rate [66.97% (73/109)] and the miscarriage rate [9.59% (7/73)] in normal weight PCOS group transferred on D5, were higher than those in the overweight PCOS group [80.57% (141/175),n P=0.008; 80.46% (140/174), n P=0.011; 20.71% (29/140), n P=0.040]. The odds of clinical pregnancy rate (an OR=1.92, 95% n CI=1.049-3.515, n P=0.034) and miscarriage rate (an OR=3.09, 95% n CI=1.209-7.915, n P=0.019) were increased in the overweight PCOS group transferred on D5. Pearson correlation analysis showed that BMI of D3 and D5 transplanted PCOS patients and D3 transplanted non-PCOS patients were positively correlated with neonatal birth weight (n r=0.144, n P=0.013; n r=0.212, n P=0.004; n r=0.137, n P<0.001), the difference was statistically significant. The odds of macrosomia (an OR=5.33, 95% n CI=1.525-18.597, n P=0.009) were increased in the overweight PCOS group transferred on D5.n Conclusion:The increase of BMI may be the main factor affecting embryo quality and leading to higher abortion rate in PCOS patients. Being overweight or obese may lead to an increase in birth weight and weight loss in PCOS patients before IVF-ET will improve embryo quality and control newborn birth weight.