Abstract
Purpose
To investigate the association between IR and pregnancy outcomes in URIF patients, as well as to evaluate the potential benefits of metformin in improving pregnancy outcomes in this population.
Methods
A total of 250 women diagnosed with URIF, undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) from January 2019 to February 2022, were recruited in this study. The patients were divided into IR group and non-IR group according the homeostasis model assessment (HOMA) index. IR patients were further classified based on whether they received metformin therapy. Primary outcomes were the clinical pregnancy rate, early pregnancy loss rate, and live birth rate.
Results
The clinical pregnancy and live birth rates did not differ significantly between IR and non-IR groups. However, the non-IR group displayed a lower incidence of early pregnancy loss compared to the IR group (13.77% vs. 24.11%, p < 0.05). Following adjustment for confounding factors, IR was still an independent risk factor for early pregnancy loss (OR = 1.385, 95% CI: 1.035 ~ 2.508, p < 0.05). Intriguingly, administration of metformin resulted in a notable decrease in early pregnancy loss rates within the IR group (17.19% vs. 33.33%, p < 0.05).
Conclusions
IR seems to pose little effect on the clinical pregnancy rate and live birth rate in women with URIF. However, IR might be associated with an increased risk of early pregnancy loss, and taking metformin in IR individuals could have potential benefits. These findings impart valuable insights into the management of URIF with IR.
Trial registration
Chinese Clinical Trials Register (ChiCTR2300077976), retrospectively registrated.