{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T16:42:57Z","timestamp":1790181777708,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,4,19]],"date-time":"2013-04-19T00:00:00Z","timestamp":1366329600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Although extensive evidence indicates the hyperinsulinemia directly contributes to reproductive dysfunction in polycystic ovarian syndrome (<jats:styled-content style=\"fixed-case\">PCOS<\/jats:styled-content>), influence of insulin resistance (<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content>) on assisted reproductive technology outcomes is poorly understood. In this study we aimed to evaluate the effects of <jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> on <jats:italic>in vitro<\/jats:italic> maturation\u2010<jats:italic>in vitro<\/jats:italic> fertilization\u2013embryo transfer (<jats:styled-content style=\"fixed-case\">IVM<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IVF<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">ET<\/jats:styled-content>) in patients with <jats:styled-content style=\"fixed-case\">PCOS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Women with <jats:styled-content style=\"fixed-case\">PCOS<\/jats:styled-content> (<jats:italic>n<\/jats:italic>\u00a0=\u00a0115) commencing <jats:styled-content style=\"fixed-case\">IVM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurments<\/jats:title><jats:p>IR (<jats:italic>n<\/jats:italic>\u00a0=\u00a051) and non\u2010IR (<jats:italic>n<\/jats:italic>\u00a0=\u00a064) women with <jats:styled-content style=\"fixed-case\">PCOS<\/jats:styled-content> ready to commence an <jats:styled-content style=\"fixed-case\">IVM<\/jats:styled-content> cycle were recruited. IR was diagnosed using the glucose tolerance test (<jats:styled-content style=\"fixed-case\">GTT<\/jats:styled-content>) and homeostasis model assessment (<jats:styled-content style=\"fixed-case\">HOMA<\/jats:styled-content>) index. Patients with an abnormal <jats:styled-content style=\"fixed-case\">GTT<\/jats:styled-content> and\/or <jats:styled-content style=\"fixed-case\">HOMA<\/jats:styled-content> index &gt;2\u00b74 were considered IR. Patients underwent 115 cycles of unstimulated <jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content>\u2010primed <jats:styled-content style=\"fixed-case\">IVM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Maturation, fertilization, cleavage rates, the number of good\u2010quality embryo, and blastocyst formation rates were not significantly different between groups. However, implantation (11\u00b76% <jats:italic>vs<\/jats:italic> 28\u00b77%, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0\u00b7001, respectively), clinical pregnancy (23\u00b75% <jats:italic>vs<\/jats:italic> 53\u00b71%, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0\u00b7002, respectively), and ongoing pregnancy rates (21\u00b76% <jats:italic>vs<\/jats:italic> 46\u00b79%. <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0\u00b7006, respectively) were significantly decreased in the <jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> group. The negative effect of <jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> on pregnancy outcomes remained after controlling for age, body mass index (<jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>) and lipid profiles (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 4\u00b7928, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1\u00b7735\u201313\u00b7991, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0\u00b7003).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pregnancy rate after <jats:styled-content style=\"fixed-case\">IVM<\/jats:styled-content> is impaired in <jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> patients with <jats:styled-content style=\"fixed-case\">PCOS<\/jats:styled-content>. Oocyte development and embryo quality are not affected, suggesting that the effects of hyperinsulinemia on endometrial function and implantation process underlie the decreased pregnancy rate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12099","type":"journal-article","created":{"date-parts":[[2012,11,24]],"date-time":"2012-11-24T08:28:19Z","timestamp":1353745699000},"page":"93-99","source":"Crossref","is-referenced-by-count":63,"title":["Insulin resistance does not affect early embryo development but lowers implantation rate in <i>in vitro<\/i> maturation\u2013<i>in vitro<\/i> fertilization\u2013embryo transfer cycle"],"prefix":"10.1111","volume":"79","author":[{"given":"Eun M.","family":"Chang","sequence":"first","affiliation":[{"name":"Fertility Center of CHA Gangnam Medical Center Department of Obstetrics and Gynecology CHA University Seoul 135\u2010081 Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji 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