Objective: This study aims to examine the impact of insulin resistance 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 following infertility treatment in a tertiary medical centre. A homeostasis model assessment of insulin resistant (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 PCOS 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 PCOS patients, the risk of spontaneous abortion in these patients can be raised. Patients with IR should been advised to improve their insulin sensitivity, through lifestyle change or medical intervention before infertility treatment in order to reduce their risk of spontaneous abortion.