Effects of Metabolic Syndrome on Pregnancy Outcomes in Women Without Polycystic Ovary Syndrome.
Level 3 - non-randomized controlled study
Retrospective cohort study comparing clinical IVF/ICSI outcomes between exposed (MetS) and unexposed controls.
PubMed 39224458 · doi:10.1210/jendso/bvae143
What was done
A retrospective cohort study evaluated 8,539 women without polycystic ovary syndrome (PCOS) undergoing their first in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycle at a single reproductive health center in China between 2017 and 2020. The cohort included 1,147 women with metabolic syndrome (MetS) and 7,392 without (control group). The primary outcome was live birth rate, and secondary outcomes included maternal and neonatal complications.
What was found
Women in the MetS group had a lower live birth rate compared to controls (50.6% vs 54.9%, adjusted odds ratio [aOR] 0.87, 95% CI 0.75–1.00, P = .045). MetS was associated with increased risks of late miscarriage (5.8% vs 3.3%, aOR 1.52, 95% CI 1.02–2.27, P = .041), gestational diabetes mellitus (13.7% vs 7.0%, aOR 1.84, 95% CI 1.30–2.60, P = .001), hypertensive disorders of pregnancy (7.8% vs 3.5%, aOR 1.79, 95% CI 1.14–2.83, P = .012), and preterm birth (9.0% vs 4.4%, aOR 2.03, 95% CI 1.33–3.08, P = .001). Singleton newborns in the MetS group had higher rates of large for gestational age (33.3% vs 20.5%, aOR 1.66, 95% CI 1.31–2.13, P < .001) and lower rates of small for gestational age (2.7% vs 6.2%, aOR 0.48, 95% CI 0.25–0.90, P = .023).
Why it matters
This study shows that metabolic syndrome independently impairs IVF/ICSI outcomes and increases perinatal risks even in the absence of PCOS, supporting pre-conception metabolic screening and intervention.
Limits
The study is observational and retrospective, conducted at a single center, which limits generalizability and introduces potential selection bias. Residual confounding from unmeasured dietary, lifestyle, or treatment variables cannot be ruled out, and the primary live birth finding was of borderline statistical significance (upper 95% CI bound of 1.00).
Cited by
- supports Metabolic function influences the quality of eggs, sperm, and embryos, as well as hormone signaling, conception rates, and IVF success rates.