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Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2025, vol. 31, issue4
Subject Area: Medicine
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DOI: 10.5272/jimab.2025314.6615
Published online: 17 November 2025
Original article
J of IMAB. 2025 Oct-Dec;31(4):6615-6618
IMPACT OF INSULIN RESISTANCE ON PREGNANCY AND NEONATAL OUTCOMES IN WOMEN UNDERGOING IN VITRO FERTILIZATION: A COMPARATIVE COHORT STUDY
Tsvetomir Ivanov1, 2
, Borislav Popov1, Boncho Grigorov1, Antonia Grigorova1
,
1) Department of Molecular Biology, Immunology and Medical Genetics, Medical Faculty, Trakia University, Stara Zagora, Bulgaria.
2) New Life Fertility center, Plovdiv, Bulgaria.
ABSTRACT:
Background: Insulin resistance (IR) is a common metabolic disorder associated with obesity, polycystic ovary syndrome (PCOS), and infertility. Its influence on pregnancy outcomes in assisted reproductive technologies (ART), particularly in vitro fertilization (IVF), remains a subject of ongoing debate. This study aimed to compare maternal, neonatal, and early pregnancy outcomes between insulin-resistant and non-insulin-resistant women undergoing IVF.
Methods: We conducted a retrospective cohort study including women who achieved pregnancy following IVF, stratified by IR status. Data on maternal characteristics (age, BMI), pregnancy outcomes (missed abortion, live birth), and neonatal parameters (birth weight, length, and sex) were analyzed. Statistical comparisons utilized independent t-tests and chi-square tests. A post hoc power analysis assessed the adequacy of the sample size for detecting differences in abortion rates.
Results: A total of 84 pregnancies were analyzed: 19 in the IR group and 65 in the non-IR group. IR patients were younger (31.6 ± 3.7 vs. 34.5 ± 4.1 years; p = 0.018) and had higher BMI (27.9 ± 3.2 vs. 22.3 ± 2.9 kg/m²; p = 0.0025). No significant differences were found in neonatal birth weight (p = 0.579), length (p = 0.5712), fetal sex distribution (p = 0.3207), or missed abortion rates (p = 0.619).
Conclusions: Despite differences in maternal age and BMI, insulin resistance did not significantly impact neonatal anthropometrics or early pregnancy loss in IVF-conceived pregnancies. These findings suggest that IR may not independently impair pregnancy outcomes in the context of well-controlled ART protocols.
Keywords: Insulin resistance, In vitro fertilization (IVF), Assisted reproductive technology (ART), Neonatal outcomes, Maternal BMI, Early pregnancy loss, Metabolic syndrome,
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Please cite this article as: Ivanov T, Popov B, Grigorov B, Grigorova A. Impact of insulin resistance on pregnancy and neonatal outcomes in women undergoing in vitro fertilization: A comparative cohort study. J of IMAB. 2025 Oct-Dec;31(4):6615-6618. [Crossref - 10.5272/jimab.2025314.6615]
Correspondence to: Antonia Grigorova, Department of Molecular Biology, Immunology and Genetics, Faculty of Medicine, Trakia University; 11, Armeiska Str., 6000 Stara Zagora,Bulgaria; E-mail: antoniya.grigorova@trakia-uni.bg
REFERENCES:
1. Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev. 1997 Dec;18(6):774-800. [PubMed]
2. Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab. 1999 Jan;84(1):165-9. [PubMed]
3. Palomba S, Santagni S, Falbo A, La Sala GB. Complications and challenges associated with polycystic ovary syndrome: current perspectives. Int J Womens Health. 2015 Jul 31;7:745-63. [PubMed]
4. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004 Jan;81(1):19-25. [PubMed]
5. Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev. 2012 Dec;33(6):981-1030. [PubMed]
6. Gonzalez F. Inflammation in polycystic ovary syndrome: underpinning of insulin resistance and ovarian dysfunction. Steroids. 2012 Mar 10;77(4):300-5. [PubMed]
7. Vanky E, Stridsklev S, Heimstad R, Romundstad P, Skogøy K, Kleggetveit O, et al. Metformin versus placebo from first trimester to delivery in polycystic ovary syndrome: a randomized, controlled multicenter study. J Clin Endocrinol Metab. 2010 Dec;95(12):E448-55. [PubMed]
8. Luo Z, Wang L, Wang Y, Fan Y, Jiang L, Xu X, Du Y, Hao G. Impact of Insulin Resistance on Ovarian Sensitivity and Pregnancy Outcomes in Patients with Polycystic Ovary Syndrome Undergoing IVF. J Clin Med. 2023 Jan 19;12(3):818. [PubMed]
9. Imterat M, Agarwal A, Esteves SC, Meyer J, Harlev A. Impact of Body Mass Index on female fertility and ART outcomes. Panminerva Med. 2019 Mar;61(1):58-67. [PubMed]
10. Ban M, Sun Y, Chen X, Zhou X, Zhang Y, Cui L. Association between maternal polycystic ovarian syndrome undergoing assisted reproductive technology and pregnancy complications and neonatal outcomes: a systematic review and meta-analysis. J Ovarian Res. 2024 Jan 6;17(1):6. [PubMed]
11. Palomba S, Orio F Jr, Falbo A, Russo T, Caterina G, Manguso F, et al. Metformin administration and laparoscopic ovarian drilling improve ovarian response to clomiphene citrate (CC) in oligo-anovulatory CC-resistant women with polycystic ovary syndrome. Clin Endocrinol (Oxf). 2005 Dec;63(6):631-5. [PubMed]
12. Wu S, Wu Y, Fang L, Lu X. Association of insulin resistance surrogates with live birth outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization. BMC Pregnancy Childbirth. 2025 Jan 11; 25(1): 25. [PubMed]
13. Zhang R, Wang X, Mo M, Liu Z, Liu S. Insulin resistance as a determinant of fertilization efficiency in polycystic ovary syndrome patients undergoing IVF/ICSI: a retrospective cohort study. Reprod Biol Endocrinol. 2025 Sep 1;23(1):120. [PubMed]
14. Kalem MN, Kalem Z, Sarı T, Ateş C, Gürgan T. Effect of body mass index and age on in vitro fertilization in polycystic ovary syndrome. J Turk Ger Gynecol Assoc. 2016 Jan 12;17(2):83-90. [PubMed]
15. Jakubowicz DJ, Iuorno MJ, Jakubowicz S, Roberts KA, Nestler JE. Effects of metformin on early pregnancy loss in the polycystic ovary syndrome. J Clin Endocrinol Metab. 2002 Feb;87(2):524-9. [PubMed]
16. Lord JM, Flight IH, Norman RJ. Metformin in polycystic ovary syndrome: systematic review and meta-analysis. BMJ. 2003 Oct 25;327(7421):951-3. [PubMed ]
17. Nybo Andersen AM, Wohlfahrt J, Christens P, Olsen J, Melbye M. Maternal age and fetal loss: population based register linkage study. BMJ. 2000 Jun 24;320(7251):1708-12. [PubMed]
Received: 05 August 2025
Published online: 17 November 2025