Influence of Obesity and Insulin Resistance on the Reproductive Outcome of Iraqi Women Undergoing Intracytoplasmic Sperm Injection

Abstract

Background: Insulin resistance (IR) is commonly associated with obesity, which plays a role in the pathogenesis of reproductive disorders. Objectives: To evaluate the impact of insulin resistance and obesity on ICSI outcomes in Iraqi infertile females. Methods: Ninety women who were unable to conceive received an intracytoplasmic sperm injection and have various infertility causes; Age range: 18–40 participated in this prospective clinical cross-sectional study. Three groups of patients were formed based on their body mass index (BMI) rankings. The ovarian hyperstimulation antagonist protocol was administered to all women. Serum glucose, insulin and HOMA-IR were measured for all participants on the ovum pickup day. In addition, the results of ICSI were determined. Results: The insulin levels and HOMA-IR were significantly higher in obese females than in overweight and normal weight groups. There was significantly lower BMI, waist/hip ratio, and HOMA-IR in pregnant females when compared with non-pregnant ladies. There is a significant negative correlation between fasting insulin, HOMA-IR with metaphase II oocytes, maturation rate, grade 1 embryos and pregnancy outcome. The cutoff values of fasting serum insulin and HOMA-IR levels were ≤ 4.64 (ng/ml) and ≤ 1.1, respectively, as predictors of positive pregnancy in women undergoing ICSI. Conclusions: Insulin resistance impairs the ICSI outcomes of infertile women. Furthermore, obesity may increase the risk of insulin resistance in infertile women; therefore, enhancing HOMA-IR and BMI will positively impact ICSI outcomes.