Role of atherogenic indices in predicting infertility in polycystic ovary syndrome

Abstract

Objective: The aim of the study was to assess the predictive value of the triglyceride-glucose index and atherogenic indices for infertility in women with polycystic ovary syndrome.

Methods: This prospective, single-center, non-randomized observational study was conducted on 279 women diagnosed with polycystic ovary syndrome from May to December 2023. Women with polycystic ovary syndrome were grouped into two groups: those with infertility and those without infertility. Demographic, hormonal, and clinical parameters were studied. The statistical study employed IBM SPSS (Statistical Package for the Social Sciences) Statistics 22 to analyze the distribution of variables, assessing normality and comparing categorical and continuous data. Descriptive statistics were computed, with categorical and continuous data compared using appropriate tests (chi-square, Student's t-test, and Mann-Whitney U). Multivariable logistic regression identified independent predictors of infertility, with a significance level set at 0.05.

Results: Infertile women with polycystic ovary syndrome had significantly higher plasma levels of dehydroepiandrosterone sulfate (p=0.001), testosterone (p=0.005), insulin (p=0.041), Homeostasis Model Assessment of Insulin Resistance (p=0.029), prolactin (p=0.018), triglycerides (p<0.001), triglyceride/high-density lipoprotein (p=0.001), atherogenic index of plasma (p=0.011), triglyceride-glucose index (p=0.001), and lipoprotein combine index (p=0.007) compared to the fertile women with polycystic ovary syndrome. Correlation analysis showed that the triglyceride-glucose index correlated with the Homeostasis Model Assessment of Insulin Resistance (r=0.402, p<0.001) and total testosterone (r=0.191, p=0.001). Multivariable analysis identified age (OR 1.189, 95%CI 1.122-1.263, p<0.001), prolactin (OR 1.040, 95%CI 1.004-1.077, p=0.029), and triglyceride-glucose index (OR 2.473, 95%CI 1.404-4.177, p<0.001) as independent predictors of infertility.

Conclusion: This study suggests a more atherogenic lipid profile in infertile women with polycystic ovary syndrome, suggesting a significant link between dyslipidemia and infertility. The triglyceride-glucose index proves to be a reliable, non-invasive marker of insulin resistance and may aid in identifying women at higher risk for infertility, facilitating earlier, targeted interventions.