What is the effect of abnormal insulin on fertility outcomes in polycystic ovarian syndrome?

This study investigated the effect of abnormal insulin responses (AIRs) on fertility outcomes in women with polycystic ovarian syndrome (PCOS). They found that AIRs can predict fertility outcomes in these patients.

Polycystic ovarian syndrome (PCOS) is a common cause of infertility. Cysts on the ovaries can prevent normal ovulation. There is also an excess production of testosterone (male sex hormone). Women with PCOS may undergo ovulation induction (OI) in order to harvest eggs for in vitro fertilization (IVF). OI uses medication to stimulate the release of eggs (oocytes) from the ovaries.

Insulin resistance (IR) is another common PCOS symptom. The body does not respond to the effect of insulin leading to high insulin levels (hyperinsulinemia, HIN). Some evidence suggests that IR and HIN play a role in PCOS. Improving IR can reduce testosterone levels and recover normal ovulation. Due to fertility issues, many patients with PCOS undergo IVF. It is unclear if the IR and HIN have an effect on fertility outcomes in these patients.

This study included 1000 patients with PCOS. The data was analyzed from medical records. IR was assessed using blood test results. HOMA-IR was calculated to measure IR. This compares the level of fasting insulin (FIN) to blood glucose. Fertility hormones were also measured. Fertility outcomes including conception rate (CR), pregnancy rate (PRs), miscarriage rate (MR) and live birth rate (LBR) were compared.

FIN and HOMA-IR were related to fertility outcomes. As FIN increased, ovulation rates, CR, PR, and LBR were reduced. A higher HOMA-IR was also associated with lower rates of these fertility outcomes.

The authors concluded that AIRs predict fertility outcomes in patients with PCOS.

This study was exploratory. It is unclear if treatment for AIRs has an effect on FOs. More investigation is needed.

If you have any concerns regarding infertility please consult with your physician.