Effect of insulin resistance in PCOS on clinical outcomes during the first embryo transfer in in vitro fertilization treatment
10.3760/cma.j.cn101441-20210908-00401
- VernacularTitle:多囊卵巢综合征女性胰岛素抵抗对体外受精-胚胎移植助孕结局的影响
- Author:
Yuanhui CHEN
1
;
Xiao HAN
1
;
Ruixiao ZHANG
1
;
Tangmiao LUO
1
;
Rui MA
1
;
Shuo CHANG
1
;
Cuilian ZHANG
1
Author Information
1. 郑州大学人民医院，河南省人民医院生殖医学中心，郑州 450003
- Publication Type:Journal Article
- Keywords:
Polycystic ovary syndrome;
Insulin resistance;
Fertilization in vitro;
Embryo transfer;
Clinical outcomes
- From:
Chinese Journal of Reproduction and Contraception
2023;43(1):50-56
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effect of insulin resistance (IR) on clinical outcomes after first embryo transfer during in vitro fertilization (IVF) treatment in polycystic ovarian syndrome (PCOS) patients. Methods:In this retrospective study, a total of 1 105 PCOS patients and 2 136 non-PCOS (control) patients with first embryo transfer from January 2018 to December 2020 in Reproductive Medical Center, Henan Provincial People's Hospital were recruited. All the patients were divided into four groups according to whether they had IR or not: PCOS with IR group (group A1); PCOS without IR (group A2); control with IR (group B1); control without IR (group B2). Baseline data and clinical outcomes were compared among the four groups.Results:1) There were significant differences in number of oocytes punctured (16.8±8.1, 17.8±7.9, 12.6±6.2, 13.4±6.2; P<0.001), number of oocytes retrieved (14.2±7.9, 15.3±7.7, 11.5±6.0, 12.3±6.3; P<0.001), the rate of oocytes retrieved [84.6% (8 518/10 070), 86.1% (7 738/8 986), 91.8% (8 346/9 096), 91.9% (17 367/18 898); P<0.001], the number of mature oocytes (12.1±7.0, 13.0±7.0, 9.7±5.3, 10.4±5.5; P<0.001), the number of two pronuclei (2PN) cleavage embryos (8.2±5.3, 9.0±5.4, 6.7±4.1, 7.4±4.3; P<0.001), the number of available embryos (7.1±4.8, 7.6±4.9, 5.7±3.7, 6.4±3.9; P<0.001), the rate of available embryos [82.3% (4 207/5 110), 82.2% (3 851/4 684), 82.3% (4 124/5 008), 83.9% (8 972/10 690); P=0.008], the number of high-quality embryos (3.7±3.4, 4.0±3.5, 3.2±2.7, 3.5±2.9; P<0.001), and the rate of high-quality embryos [42.8% (2 185/5 110), 43.5% (2 037/4 684), 45.7% (2 290/5 008), 46.9% (5 009/10 690); P<0.001], among group A1, group A2, group B1 and group B2 while the M Ⅱ rate, 2PN cleavage rate and available blastocyst formation rate were similar among the four groups (all P>0.05). 2) The rate of early miscarriage rate was significantly different among the four groups [16.3% (63/387), 9.7% (34/351), 12.1% (56/464), 8.7% (82/939); P=0.001], while the clinical pregnancy rate, the implantation rate and the ectopic rate were comparable (all P>0.05). Further subgroup analysis showed that the early miscarriage rate of group A1 [16.3% (63/387)] was significantly higher than that of group A2 [9.7% (34/351), P=0.008] and group B2 [8.7% (82/939), P<0.001]. 3) Multivariate logistic regression analysis suggested that IR was the independent factor of early miscarriage ( OR=1.464, 95% CI: 1.361-2.065, P=0.019). Conclusion:IR may play an important role in the early miscarriage results in PCOS patients during IVF treatment.
