Impact of insulin resistance and obesity on intracytoplasmic sperm injection outcomes in young women with polycystıc ovary syndrome
Yigit Cakiroglu1, Emek Doger1, Fisun Vural2, Sule Yildirim Kopuk3, Birol Vural11Department of Obstetrics and Gynecology, Kocaeli University, Kocaeli, Turkey2Department of Obstetrics and Gynecology, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
3Department of Obstetrics and Gynecology, Health Science University, Umraniye Education and Research Hospital, Istanbul, Turkey
INTRODUCTION: To examine effects of body mass index (BMI) and insulin resistance (IR) on the in vitro fertilization (IVF) outcomes in women with polycystic ovary syndrome (PCOS).
METHODS: A total of 106 women with PCOS who underwent intracytoplasmic sperm injection were investigated. The patients were stratified into groups according to their BMI [healthy weight: BMI <25 kg/m2 (n=51), overweight: ≤25–29.9 kg/m2 (n=27), and obese: ≥30 kg/m2 (n=28)]. Secondly, the patients were classified based on the presence of IR (IR was considered to be present if homeostatic model assessment-IR was >2.5). The main outcome measures were reproductive and IVF outcomes with respect to BMI and IR.
RESULTS: The basal hormonal evaluations, such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), LH/FSH, estradiol, testosterone, DHEAS, AMH, and antral follicle counts, were similar between the groups of BMI and IR. The number of retrieved oocytes, MII oocytes, embryo counts, and fertilization and pregnancy rates were similar between lean and overweight/obese PCOS with and without IR. Even though pregnancy and delivery rates per started cycle and embryo transfer were higher in healthy-weight women with PCOS than in overweight/obese patients, it did not reach statistical significance.
DISCUSSION AND CONCLUSION: Reproductive outcomes in women with PCOS according to BMI and IR were similar. Neither BMI nor IR had an independent effect on ovarian response and IVF success in young women with PCOS.
Polikistik over sendromlu hastalarda vücut kitle indeksi ve insulin direncinin yardımla üreme üzerine etkisi
Yigit Cakiroglu1, Emek Doger1, Fisun Vural2, Sule Yildirim Kopuk3, Birol Vural11Kocaeli Üniversitesi Tıp Fakültesi, Khd Anabilim Dalı, Kocaeli2Haydarpaşa Eğitim ve Araştırma Hastanesi, Khd Anabilim Dalı, İstanbul
3Sağlık Bilimleri Üniversitesi, Ümraniye Eğitim ve Araştırma Hastanesi, Khd Anabilim Dalı, İstanbul
GİRİŞ ve AMAÇ: Bu çalışmada, vücut kitle indeksinin (VKİ) ve İnsulin direncinin (İR) Polikistik over sendromu (PKOS) ile ilişkili üreme parametrelerine etkisinin araştırılması hedeflenmiştir.
YÖNTEM ve GEREÇLER: PKOS tanılı 106 hastanın oosit toplama günü (OPU) kilo ve boy ölçüldü. VKİ`ne göre hastalar üç alt gruba ayrıldı; grup I <25 kg/m2 (n=51), (normal), grup II ≤25-29.9 kg/m2 (n=27) (kilolu) ve grup III ≥30 kg/m2 (n=28)(obez). İkinci olarak hastalar HOMA-IR indekslerine göre iki gruba ayrıldı (IR: HOMA-IR >2.5).
BULGULAR: FSH, LH, LH/FSH, E2, testosterone, DHEAS, AMH and antral follikul sayıları gruplar arası benzerdi. MII oosit, embryo sayısı, fertilizasyon ve gebelik oranları insulin direnci olan ve olmayan PKOS tanılı zayıf, kilolu ve obez grubunda anlamlı farklılık saptanmadı. Siklus başına gebelik ve doğum oranı zayıf grupta; kilolu ve obez grubuna göre daha yüksek çıkmasına rağmen anlamlı düzeyde saptanmadı.
TARTIŞMA ve SONUÇ: VKİ ile İR etkisine bakıldığında PKOS' lu kadınlarda reproduktif sonuçlar benzer iken, PKOS tanılı kadınlarda VKİ ve İR`nin over cevabı ve IVF başarısı üzerine bağımsız bir etkisi vardır.
Corresponding Author: Yigit Cakiroglu, Türkiye
Manuscript Language: English