Impact of Central Obesity on Women with Polycystic Ovary Syndrome Undergoing In Vitro Fertilization.

Abstract

Central obesity (CO) is a defining characteristic of polycystic ovary syndrome (PCOS) and PCOS-induced disorders are likely to be exacerbated in the presence of CO. This study aims to evaluate the impact of CO on infertile women with PCOS undergoing in vitro fertilization (IVF).It is a retrospective and case-control study. One hundred eighty-eight infertile PCOS women undergoing IVF were divided into CO group (n = 70, waist circumference [WC] ≥80 cm) and noncentral obesity (NCO) group (n = 118, WC <80 cm). Baseline characteristics, parameters of ovarian stimulation and laboratory, and pregnancy outcomes were compared between two groups. After controlling for body mass index (BMI), WC positively correlated with fasting insulin (r = 0.210, p = 0.007), homeostatic model assessment for insulin resistance (r = 0.249, p = 0.006) and free androgen index (r = 0.249, p = 0.006). Compared with NCO group, CO group had significantly increased endocrine and metabolic disorders and needed significantly higher dose of gonadotropins, longer duration of ovarian stimulation (p < 0.05), but had significantly lower peak serum estradiol level (p < 0.01) and less oocytes retrieved (p = 0.032). CO group had significantly lower live birth and implantation rates (53.8% vs. 86.8%, p = 0.001; and 24.3% vs. 36.3%, p = 0.019, respectively) and higher early spontaneous miscarriage rate (38.5% vs. 7.5%, p = 0.002). For the multivariate analysis, by adjusting for age, BMI, insulin resistance, and hyperandrogenism (HA), CO was significantly independent risk factor for early miscarriage (adjusted relative ratio = 16.87, 95% confidence interval = 2.15-132.70, p = 0.007). CO is associated with insulin resistance, hyperinsulinemia, and HA independent of BMI and is associated with poor pregnancy outcome in infertile women with PCOS undergoing IVF.