Authors
Xi Bai, RuiQi Chang, Mengjiao Qing, Beilei Jiang, Chanyu Zhang
Published in
Human fertility (Cambridge, England). Volume 28. Issue 1. Pages 2526768. Epub Jul 20, 2025.
Abstract
This retrospective cohort study evaluated 1,193 women undergoing first fresh IVF cycles to assess the effects of insulin resistance (IR) and overweight/obesity on outcomes. Participants were stratified by BMI and IR status. Overweight/obese women without IR exhibited comparable IVF outcomes to normal-weight controls. Untreated IR, however, significantly impaired outcomes, including fewer oocytes retrieved, 2PN zygotes, available embryos, and good-quality embryos all p ≤ 0.002), alongside lower fresh cycle live birth rates (34.4% vs. 53.3%, p = 0.038), implantation rates (32.1% vs. 47.8%, p = 0.023), cumulative pregnancy rates (45.8% vs. 68.4%, p = 0.001), and cumulative live birth rates (41.7% vs. 58.4%, p = 0.006). Notably, IR correction improved 2PN zygote formation (p = 0.026), numbers of available embryos (p = 0.021), fresh cycle live birth rates (57.6% vs. 34.4%, p = 0.034), cumulative pregnancy rates (63.2% vs. 45.8%, p = 0.018), and cumulative live birth rates (56.8% vs. 41.7%, p = 0.041). Multivariate analysis confirmed homeostasis model assessment of insulin resistance (HOMA-IR) as an independent negative predictor of live birth (OR = 0.49, 95% CI 0.30-0.82, p = 0.006). The findings challenge BMI-centric risk stratification in ART, emphasizing IR's role in compromising embryo quality and clinical outcomes. Preemptive IR screening and treatment in overweight/obese women are crucial.
PMID:
40684365
Bibliographic data and abstract were imported from PubMed on 20 Jul 2025.
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