Insulin Resistance Adversely Affect IVF Outcomes in Lean Women Without PCOS

OBJECTIVE: To investigate the effects of insulin resistance (IR) on IVF outcomes and a potential underlying mechanism in lean women without PCOS. DESIGN: A prospective cohort study at the University Clinic. SETTING: IVF center at the University setting. PATIENTS: A total of 155 lean women (body mass index <25) without PCOS undergoing IVF cycle. INTERVENTION: Patients were allocated to IR and non-IR groups based on HOMA-M(120). MAIN OUTCOME MEASURE(S): IVF outcomes, including egg quality, the percentage of mature oocytes, fertilization rate, blastocyst formation rate, advanced embryo rate, and cumulative live birth rate were investigated. Auto-immune parameters, peripheral blood immunophenotypes, thyroid hormone, homocysteine, and 25-OH-vitamin D(3) (25-OH-VD(3)) levels were analyzed. RESULTS: The percentage of mature oocytes and blastocyst formation rate were significantly lower in the IR group as compared with those of the non-IR group (p<0.05, respectively). The proportion of peripheral blood CD19(+) B cells was significantly higher in the IR group than those of the non-IR group (p<0.05). Homocysteine, 25-OH-VD(3,) and auto-immune parameters were the same between the two groups. CONCLUSION: In lean infertile women without PCOS, IR is associated with the decreased percentage of mature eggs and poor embryo quality in which B cell immunity may play a role.