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Impact of insulin resistance on in vitro fertilization outcomes in overweight and obese women: a retrospective cohort study

Year: 2025
Type: article
Study design: Observational Study
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.
DOI: 10.1080/14647273.2025.2526768
Language: English
Field: Medicine
Open Access status: diamond
OpenAlex ID: W4412494143
FWCI: 0.7
Cites: 37
Cited by: 1
Related to: 10