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Insulin Resistance Increases the Risk of Spontaneous Abortion after Assisted Reproduction Technology Treatment

Reproductive Medical Centre (L.T., H.S., Q.L.), Peking University, People’s Hospital, Xizhimen, Beijing, China 100044; and Research Centre for Reproductive Health (R.J.N., J.W.), Department of Obstetrics and Gynaecology, University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia 5011, Australia

Address all correspondence and requests for reprints to: Li Tian, Reproductive Medical Centre, Beijing University, People’s Hospital, No. 11 South Street, Xizhimen, Beijing, China 100044. E-mail: tianli916{at}hotmail.com.

Objective: This study aims to examine the impact of insulin resistance (IR) on the risk of spontaneous abortion in patients who received infertility treatment.

Patients and Methods: This is a cohort study of 107 patients who achieved their first pregnancy after infertility treatment in a tertiary medical center. A homeostasis model assessment of IR (HOMA-IR) was carried out. Patient demographic characteristics and pregnancy outcome were also recorded. Statistical comparison was made between patients with and without IR. Logistical regression analysis was used to assess the effect of IR and several other factors simultaneously on the risk of spontaneous abortion.

Results: The incidence of spontaneous abortion was 17.8%. The association of IR with the risk of spontaneous abortion was significant after adjusting for other risk factors. The effect of overweight/obesity and polycystic ovarian syndrome was not statistically significant in the multivariate model.

Discussion and Conclusion: This study suggested that IR was an independent risk factor for spontaneous abortion. Because of the high prevalence of IR in obese or polycystic ovarian syndrome patients, the risk of spontaneous abortion in these patients can be raised. Patients with IR should be advised to improve their insulin sensitivity through lifestyle change or medical intervention before infertility treatment to reduce their risk of spontaneous abortion.

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