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Meta-Analysis
. 2021 Mar 30:12:657889.
doi: 10.3389/fendo.2021.657889. eCollection 2021.

Improvement of Insulin Sensitivity Increases Pregnancy Rate in Infertile PCOS Women: A Systemic Review

Yuqi Liu  1   2 , Juan Li  1   2 , Zhe Yan  1   2 , Dan Liu  3 , Jinfang Ma  1   2 , Nanwei Tong  1   2
Affiliations
Meta-Analysis

Improvement of Insulin Sensitivity Increases Pregnancy Rate in Infertile PCOS Women: A Systemic Review

Yuqi Liu et al. Front Endocrinol (Lausanne). .

Abstract

Background: Polycystic ovary syndrome (PCOS) is the most common cause of infertility in reproductive-age women. Insulin increases steroidogenesis, deranges granulosa cell differentiation, and affects follicle growth. However, results from randomized control trials (RCTs) were heterogeneous, and little strong evidence associated actual achievement of insulin sensitivity (IS) improvement with reproductive outcomes.

Objectives: To identify evidence of the reproductive benefit of IS improvement in infertile PCOS women by analyzing eligible RCTs.

Search strategy: Different search strategies with unlimited keywords, including treatment, therapy, intervention, polycystic ovary syndrome/PCOS, insulin resistance, pregnancy, conceive, live birth, and randomized controlled trials/RCT were used in databases including Pubmed, Embase, and Web of Science to November 20th, 2021.

Data collection and analysis: Two authors independently abstracted study details and assessed study quality.

Main results: Ten RCTs that covered different races and met the inclusion criteria were included for analysis and discussion. Clinical pregnancy rate was increased in infertile PCOS women when they had significant improvement of IS after treatment regardless of the various interventions (non-surgical). The benefits of IS improvement appeared superior in PCOS women without severe obesity. The effect of IS improvement on pregnancy rate was independent of the change of BMI.

Conclusions: Nonsurgical therapeutic strategies that promote superior IS improvement may aid infertile PCOS women to increase their possibility of successful pregnancy regardless of the various interventions. The improvement of IS might be more important than the reduction of BMI in the improvement of pregnancy rate in infertile PCOS women.

Keywords: insulin sensitivity; insulin sensitizers; polycystic ovary syndrome (PCOS); randomized controlled trials (RCT); review – systematic.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart showing literature search and study selection.
Figure 2
Figure 2
The cochrane collaboration risk of bias evaluation for the included studies.
See this image and copyright information in PMC

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References

    1. March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod (2010) 25(2):544–51. 10.1093/humrep/dep399 - DOI - PubMed
    1. Nandi A, Chen Z, Patel R, Poretsky L. Polycystic ovary syndrome. Endocrinol Metab Clin North Am (2014) 43(1):123–47. 10.1016/j.ecl.2013.10.003 - DOI - PubMed
    1. Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. . Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod (2018) 33(9):1602–18. 10.1093/humrep/dey256 - DOI - PMC - PubMed
    1. Homburg R. Clomiphene citrate–end of an era? A mini-review. Hum Reprod (2005) 20(8):2043–51. 10.1093/humrep/dei042 - DOI - PubMed
    1. Dellapasqua S, Colleoni M. Letrozole. Expert Opin Drug Metab Toxicol (2010) 6(2):251–9. 10.1517/17425250903540246 - DOI - PubMed