Association of insulin resistance with in vitro fertilization outcomes in women without polycystic ovarian syndrome: potential improvement with metformin treatment
Abstract
STUDY QUESTION: What is the association between insulin resistance (IR), metformin treatment, and the outcomes of IVF in IR infertile women without polycystic ovarian syndrome (non-PCOS)?
SUMMARY ANSWER: IR among non-PCOS infertile women was associated with worse IVF outcomes compared to insulin-sensitive (IS) infertile women, and metformin treatment prior to embryo transfer (ET) was associated with improved reproductive outcomes.
WHAT IS KNOWN ALREADY: Endometrium insulin-mediated glucose uptake is essential in human embryo implantation, decidualization, and pregnancy. IR has been described as a risk factor for spontaneous abortion in women undergoing IVF. While this condition has been studied in the context of PCOS and its association with poorer reproductive outcomes, with Metformin proposed as a possible treatment, there is a lack of studies examining the role of IR in non-PCOS infertile women.
STUDY DESIGN, SIZE, DURATION: Observational, multicenter, retrospective cohort study with clinical data from private fertility centers in Spain collected between January 2015 to November 2023. From 1659 patients a total of 1033 women met all the inclusion criteria and had available data for analysis.
PARTICIPANTS/MATERIALS, SETTING, METHODS: The study included non-PCOS infertile women between 18 and 45 years old, with a BMI ≤30 kg/m2, available oral glucose tolerance test (OGTT) results, and an indication for IVF and ET using donated oocytes. The study population was stratified…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 1,659 participants or records.
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