Effect of insulin resistance in couples on IVF-ET treatment outcomes

To investigate the effect of insulin resistance (IR) in primary infertile couples on pregnancy outcomes in fresh cycle embryo transfer.

A total of 101 primary infertile couples who underwent first IVF-ET/ICSI assisted conception with fresh cycle embryo transfer in our reproductive medical center from October 2022 to October 2023 were retrospectively included. According to whether they had combined IR unilaterally, these couples were divided into female IR group (n=49) and female non-IR group (n=52), and male IR group (n=49) and male non-IR group (n=52). The basic data, ovulation promotion, embryo transfer and pregnancy outcome were compared between the female IR group and non-IR group, and between the male IR group and non-IR group. Logistic regression analysis was applied to determine the effect of IR on pregnancy outcome and laboratory indicators of ovulation promotion.

①The IR female group had significantly higher body weight and BMI, and lower antral follicle count (AFC) when compared with the non-IR female group (P<0.05). ②Female fasting blood glucose was negatively correlated with the number of acquired eggs, number of metaphase Ⅱ (MII) oocytes, number of transferable embryos, and number of high-quality embryos (P<0.05); and both female fasting insulin level and female HOMA-IR were positively correlated with the days and total amount of gonadotropin (GN) (P<0.05). ③Embryo implantation and clinical pregnancy rates were significantly lower in the female IR group than the female non-IR group (P<0.05). ④The male IR group had significantly higher BMI than the male non-IR group (P<0.05). ⑤Embryo implantation rate and clinical pregnancy rate were in declining trend in all following 3 groups of couples (both IR groups, single IR group, and neither IR group). ⑥Female fasting blood glucose level showed a negative effect on number of acquired eggs, number of MII oocytes, number of transferable embryos, and number of high-quality embryos.

IR affects embryo quality in IVF/ICSI cycles in women with primary infertility; IR in couples with primary infertility negatively affects embryo implantation rates and clinical pregnancy rates in IVF/ICSI cycles.