Hyperinsulinaemia, insulin resistance may reduce fertility in women with PCOS
Hyperinsulinaemia and insulin resistance (IR) appear to exacerbate phenotypic characteristics, reproductive endocrine disorders, and glucose and lipid metabolic dysfunction in polycystic ovary syndrome (PCOS) patients and therefore lead to reduced fertility in these women, a study has found.
Researchers looked at 1,000 PCOS patients, examining serum insulin levels and homeostasis model assessment‐insulin resistance (HOMA‐IR) parameters in relation to the following outcome measures: anthropometric, biometric and ultrasound parameters at baseline, as well as ovulation, conception, pregnancy, live birth, and pregnancy loss.
In terms of anthropometric measures and phenotypes, weight, waist and hip circumference, body mass index (BMI), waist‐to‐hip ratio (WHR), acanthosis nigricans score, and menstrual period were significantly correlated with fasting insulin (FIN) and HOMA‐IR.
Biochemical assays of reproduction and metabolism showed that free androgen index (FAI) had a significant correlation with both FIN and HOMA‐IR (p<0.001 for both), whereas free testosterone was only associated with FIN.
With respect to glucose and metabolic profile, FIN and HOMA‐IR were positively associated with fasting glucose, cholesterol, triglycerides, low‐density lipoprotein, Apo B and metabolic syndrome, but were negatively associated with high‐density lipoprotein.
Predictive analysis revealed that the levels of FIN and HOMA‐IR influenced the fertility outcome in PCOS, such that higher serum insulin levels and HOMA‐IR were significantly associated with decreased cycle ovulation, conception, pregnancy and live birth rates.
In light of the present data, reducing IR in PCOS patients play an important role in restoring ovarian function, improving clinical symptoms, increasing fertility and reducing long‐term complications, according to the researchers.