PDF(Pubmed)
Abstract：
UNASSIGNED: To explore the effects of insulin resistance (IR) on embryo quality and pregnancy outcomes in women with or without polycystic ovary syndrome (PCOS) undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).
UNASSIGNED: A retrospective cohort study concerning patients with/without PCOS who received gonadotropin-releasing hormone (GnRH)-antagonist protocol for IVF/ICSI from January 2019 to July 2022 was conducted. All the patients included underwent oral glucose tolerance test plus the assessment of insulin release within 6 months before the controlled ovarian stimulation. The Matsuda Index was calculated to diagnose IR. Two populations (PCOS and non-PCOS) were included and each was divided into IR and non-IR groups and analyzed respectively. The primary outcome was the high-quality day 3 embryo rate.
UNASSIGNED: A total of 895 patients were included (751 with PCOS and 144 without PCOS). For patients with PCOS, the IR group had a lower high-quality day 3 embryo rate (36.8% vs. 39.7%, p=0.005) and available day 3 embryo rate (67.2% vs. 70.6%, p<0.001). For patients without PCOS, there was no significant difference between the IR and non-IR groups in high-quality day 3 embryo rate (p=0.414) and available day 3 embryo rate (p=0.560). There was no significant difference in blastocyst outcomes and pregnancy outcomes for both populations.
UNASSIGNED: Based on the diagnosis by the Matsuda Index, IR may adversely affect the day 3 embryo quality in patients with PCOS but not pregnancy outcomes. In women without PCOS, IR alone seems to have less significant adverse effects on embryo quality than in patients with PCOS. Better-designed studies are still needed to compare the differences statistically between PCOS and non-PCOS populations.
UNASSIGNED: A retrospective cohort study concerning patients with/without PCOS who received gonadotropin-releasing hormone (GnRH)-antagonist protocol for IVF/ICSI from January 2019 to July 2022 was conducted. All the patients included underwent oral glucose tolerance test plus the assessment of insulin release within 6 months before the controlled ovarian stimulation. The Matsuda Index was calculated to diagnose IR. Two populations (PCOS and non-PCOS) were included and each was divided into IR and non-IR groups and analyzed respectively. The primary outcome was the high-quality day 3 embryo rate.
UNASSIGNED: A total of 895 patients were included (751 with PCOS and 144 without PCOS). For patients with PCOS, the IR group had a lower high-quality day 3 embryo rate (36.8% vs. 39.7%, p=0.005) and available day 3 embryo rate (67.2% vs. 70.6%, p<0.001). For patients without PCOS, there was no significant difference between the IR and non-IR groups in high-quality day 3 embryo rate (p=0.414) and available day 3 embryo rate (p=0.560). There was no significant difference in blastocyst outcomes and pregnancy outcomes for both populations.
UNASSIGNED: Based on the diagnosis by the Matsuda Index, IR may adversely affect the day 3 embryo quality in patients with PCOS but not pregnancy outcomes. In women without PCOS, IR alone seems to have less significant adverse effects on embryo quality than in patients with PCOS. Better-designed studies are still needed to compare the differences statistically between PCOS and non-PCOS populations.
摘要：
■探讨胰岛素抵抗（IR）对接受体外受精（IVF）/卵胞浆内单精子注射（ICSI）的多囊卵巢综合征（PCOS）患者胚胎质量和妊娠结局的影响。
进行了一项回顾性队列研究，该研究涉及2019年1月至2022年7月在IVF/ICSI中接受促性腺激素释放激素（GnRH）-拮抗剂方案的PCOS患者。所有患者在控制性卵巢刺激前6个月内接受口服葡萄糖耐量试验和胰岛素释放评估。计算Matsuda指数以诊断IR。纳入两个群体（PCOS和非PCOS），分别分为IR和非IR组进行分析。主要结果是高质量的第3天胚胎率。
■共纳入895例患者(751例PCOS患者和144例非PCOS患者)。对于PCOS患者，IR组的第3天高质量胚胎率较低(36.8%vs.39.7%,p=0.005）和第3天可用胚胎率（67.2%vs.70.6%,p<0.001)。对于没有PCOS的患者，IR组和非IR组的优质第3天胚胎率(p=0.414)和有效第3天胚胎率(p=0.560)无显著差异。这两个人群的胚泡结局和妊娠结局没有显着差异。
■根据松田指数的诊断，IR可能会对PCOS患者的第3天胚胎质量产生不利影响，但不会影响妊娠结局。在没有PCOS的女性中，与PCOS患者相比，单独的IR似乎对胚胎质量的不利影响较小。仍然需要更好设计的研究来比较PCOS和非PCOS人群之间的统计学差异。
进行了一项回顾性队列研究，该研究涉及2019年1月至2022年7月在IVF/ICSI中接受促性腺激素释放激素（GnRH）-拮抗剂方案的PCOS患者。所有患者在控制性卵巢刺激前6个月内接受口服葡萄糖耐量试验和胰岛素释放评估。计算Matsuda指数以诊断IR。纳入两个群体（PCOS和非PCOS），分别分为IR和非IR组进行分析。主要结果是高质量的第3天胚胎率。
■共纳入895例患者(751例PCOS患者和144例非PCOS患者)。对于PCOS患者，IR组的第3天高质量胚胎率较低(36.8%vs.39.7%,p=0.005）和第3天可用胚胎率（67.2%vs.70.6%,p<0.001)。对于没有PCOS的患者，IR组和非IR组的优质第3天胚胎率(p=0.414)和有效第3天胚胎率(p=0.560)无显著差异。这两个人群的胚泡结局和妊娠结局没有显着差异。
■根据松田指数的诊断，IR可能会对PCOS患者的第3天胚胎质量产生不利影响，但不会影响妊娠结局。在没有PCOS的女性中，与PCOS患者相比，单独的IR似乎对胚胎质量的不利影响较小。仍然需要更好设计的研究来比较PCOS和非PCOS人群之间的统计学差异。
