Prepregnancy Insulin Resistance and Fertility and Pregnancy Outcomes in Women With Polycystic Ovarian Syndrome.
Obstet GynecolMay 22, 2026 (epub)
Bo Hyon Yun, Seok Kyo Seo, Jacqueline Yano Maher et al.
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In 30 seconds
This multicenter randomized controlled trial analyzed the impact of prepregnancy insulin resistance on fertility and pregnancy outcomes in 746 women with polycystic ovarian syndrome (PCOS). Higher prepregnancy HOMA-IR quartiles correlated with decreased ovulation and clinical pregnancy rates, with significant differences observed (36% vs 25.5% vs 23.52% vs 26.5%; P =.005).
Key findings
- Higher prepregnancy HOMA-IR quartiles were linked to decreased ovulation rates (93.5% vs 73.8%; P <.001).
- Clinical pregnancy rates decreased with higher HOMA-IR quartiles (36% vs 18.2%; P <.001).
- Women in the highest HOMA-IR quartile had a 45.7% risk of gestational diabetes mellitus (GDM).
- Improvement in HOMA-IR during treatment was associated with increased odds of clinical pregnancy.
Why it matters
Understanding the relationship between insulin resistance and reproductive outcomes in women with PCOS is crucial for optimizing fertility treatments and minimizing pregnancy complications. Addressing insulin resistance may enhance reproductive success and improve maternal health.