Association of in vitro fertilization/intracytoplasmic sperm injection outcomes with metabolic syndrome parameters in women with polycystic ovary syndrome

OBJECTIVE: This study investigates the impact of metabolic syndrome parameters on female fertility and in vitro fertilization outcomes in women with polycystic ovary syndrome (PCOS). METHODS: A total of 812 women with PCOS undergoing ovarian stimulation for in vitro fertilization (IVF) were included in this case control retrospective study. All subjects were divided into a metabolic syndrome (MetS) group and an absence of metabolic syndrome group (non-MetS) according to the National Cholesterol Education Program Adult Treatment Panel III guidelines. RESULTS: Patients with MetS had longer infertility duration compared with those without MetS. During ovarian stimulation, those with MetS required significantly higher and longer doses of gonadotropin and had higher peak estradiol levels, fewer retrieved oocytes. The clinical pregnancy and live birth rates were statistically significantly lower in women with MetS 78/235 (33.1%) versus 272/577 (47.1%) and miscarriage rate was significantly higher in women with MetS (10.2% vs. 7.9%, P = 0.045). Multivariate logistic regression analysis showed that the MetS parameters such as triglyceride, waist circumference, and body mass index were negatively associated with the clinical pregnancy rates. In a subgroup analysis comparing fresh and frozen cycle outcomes, subjects without MetS had significantly higher clinical and live birth rates than those with MetS in both fresh and frozen transfer cycles. CONCLUSION: MetS and PCOS might have a negative impact on female fecundity, suggesting a negative association of MetS and IVF cycle stimulation characteristics and clinical pregnancy outcomes. Therefore, it is important to screen for metabolic profiles prior to IVF treatment.