The effect of metabolic syndrome on controlled ovarian stimulation outcome in infertile women with polycystic ovary syndrome undergoing assisted reproductive technology cycles

Abstract

Objective: To evaluate the effect of metabolic syndrome (MetS) diagnosis on oocyte quality and pregnancy outcomes in infertile women with polycystic ovary syndrome (PCOS) who undergoing antagonist-controlled ovarian stimulation (COS) and in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. Subject and methods: This prospective cohort study was conducted from November 2019 to November 2020 across two university-affiliated infertility centers in Iran. The PCOS diagnosis was defined according to the Rotterdam criteria. The patients prior to IVF/ICSI cycles were evaluated for MetS diagnosis. MetS was detected according to the National Cholesterol Education Program/Adult Treatment Panel III with the presence of at least three or more of the specific clinical criteria. The cycle outcomes were compared between MetS and non-MetS groups. Results: Overall, 68 eligible infertile PCOS patients with MetS diagnosis and 126 without MetS participated. The MetS diagnosis was associated with the increased requirement of gonadotropins and the COS duration significantly (P = 0.001). Although the total numbers of retrieved and MII oocytes, obtained and topquality embryos as well as clinical pregnancy and live birth rates in the MetS group were lower than those of in the non-MetS group, the differences were not statistically significant (P > 0.05). In followup of the obstetrics complications, the rate of preeclampsia was significantly higher in patients with MetS (P = 0.02). Conclusion: MetS diagnosis in PCOS patients was associated with non-significant poor COS and pregnancy outcome. Further studies with larger sample sizes are recommended to clarify the risk of MetS in patients undergoing ART cycles.

Effect of oral glucose tolerance test-based insulin resistance on embryo quality in women with/without polycystic ovary syndrome

“…However, considering several numerical differences in the embryonic outcomes between the IR and non-IR groups in the non-PCOS population, which is similar to the PCOS population, the different results between the two populations may be due to sample size and statistical power. Besides, previous clinical studies ( 17 , 21 , 48 ) did not show similar outcomes of high-quality or available D3 embryo rate in patients with PCOS, which may be related to the diagnosis of IR and the criteria for embryo morphological evaluation.…”

“…Excessive insulin and androgen may impair the quality of oocytes and induce metabolic disorders in theca cells and granulosa cells (45,46). When PCOS exists, the situation becomes more complicated due to the vicious cycle between hypothalamicpituitary-ovarian (HPO) axis disorders and metabolic disorders (47). However, considering several numerical differences in the embryonic outcomes between the IR and non-IR groups in the non-PCOS population, which is similar to the PCOS population, the different results between the two populations may be due to sample size and statistical power.…”

The Impact of Nutritional Therapy in the Management of Overweight/Obese PCOS Patient Candidates for IVF

“…Indeed, the VLCKD group showed greater weight and BMI loss, particularly in those body areas where central adiposity is concentrated. Due to the low glycemic load, the VLCKD may improve hyperglycemia, insulin sensitivity, dyslipidemia, and blood pressure, resulting in a reduction in inflammatory status [52]. In fact, lower carbohydrate intake, which is possible in the VLCKD diet but not in the Mediterranean diet, results in reduced inflammation and oxidative stress.…”