L26/O-272 Targeting insulin resistance prior to in vitro fertilisation cycle in women with polycystic ovary syndrome and metabolic syndrome: a prospective cohort study
Abstract
Does 8–12-week metabolic optimization before in vitro fertilization cycles improve outcomes in women with PCOS and metabolic syndrome, and can a prognostic model predict effectiveness?
Metabolic optimization substantially improves insulin resistance and the androgen profile, reduces ovarian stimulation burden, increases the number of mature oocytes, and improves fertilization and implantation.
PCOS is a leading cause of anovulatory infertility. Concomitant metabolic syndrome is associated with a more severe clinicsl features (insulin resistance, dyslipidaemia, hyperandrogenism, central obesity), potentially impairing ovarian responsiveness, oocyte/embryo quality and endometrial receptivity, thereby reducing ART success. However, routine practice lacks quantitative tools to assess the degree of metabolic compensation before IVF and to forecast treatment effectiveness, limiting the ability to personalize preconception preparation in PCOS with metabolic syndrome.
Prospective cohort study over a 3-year period including 128 infertile reproductive-aged women with PCOS undergoing IVF. Participants were allocated to three groups: PCOS and MetS group with routine preparation (folic acid 400 μg/day; n = 43); PCOS and MetS group receiving 8–12 weeks of metabolic optimisation (myo-inositol 2000 mg/day, metformin 1000 mg/day, alpha-lipoic acid 600 mg/day, alongside a hypocaloric diet and daily physical activity; n = 44); and only PCOS group receiving standard preparation (n = 41).
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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: 44 participants or records.
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