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

Sundus Ali Dawood; Hayder Ali Lafta Mossa; Mufeeda Ali Jwad

doi:10.54133/ajms.v6i1.580

المؤلفون

Sundus Ali Dawood High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University-Baghdad-Iraq. https://orcid.org/0009-0008-5156-2456
Hayder Ali Lafta Mossa High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad, Iraq
Mufeeda Ali Jwad High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad, Iraq https://orcid.org/0000-0002-7995-6755

DOI:

https://doi.org/10.54133/ajms.v6i1.580

الكلمات المفتاحية:

HOMA-IR، Insulin resistance، ICSI، Obesity

الملخص

الخلفية: تُعرف مقاومة الأنسولين (IR) بأنها انخفاض الحساسية أو الاستجابة للعمل الأيضي للأنسولين. ويرتبط عادة بالسمنة، التي تلعب دورا في التسبب في الاضطرابات الإنجابية.

الأهداف: تهدف هذه الدراسة إلى تقييم تأثير مقاومة الأنسولين والسمنة على نتائج الحقن المجهري عند الاناث العراقيات المصابات بالعقم.

المواد والطرق: تم حقن تسعين امرأة غير قادرة على الحمل على حقن الحيوانات المنوية داخل السيتوبلازم ولديهن أسباب عقم مختلفة. الفئة العمرية: 18-40 شارك في هذه الدراسة السريرية المستعرضة المرتقبة. تم تشكيل ثلاث مجموعات من المرضى بناءً على تصنيفات مؤشر كتلة الجسم (BMI). تم تطبيق بروتوكول مضاد تحفيز فرط المبيض لجميع النساء. تم قياس نسبة الجلوكوز في الدم والأنسولين وHOMA-IR لجميع المشاركين في يوم التقاط البويضة. وبالإضافة إلى ذلك، تم تحديد نتائج الحقن المجهري.

النتائج: كانت مستويات الأنسولين وHOMA-IR أكبر بكثيرقيمة) (P <0.001في الإناث البدينات مقارنة بمجموعات الوزن الزائد والطبيعي. كان هناك انخفاض ملحوظ في مؤشر كتلة الجسم ونسبة الخصر / الورك و HOMA-IRلدى الإناث الحوامل بالمقارنة مع السيدات غير الحوامل) القيمة p = 0.002؛ القيمة p = 0.027؛ القيمة (p = 0.001 على التوالي). هناك علاقة سلبية معنوية بين الأنسولين الصائم، HOMA-IR مع البويضات الطورية الثانية، معدل النضج، الأجنة من الدرجة الأولى ونتائج الحمل قيمة (p ≥ 0.05). كانت قيم القطع لمستويات الأنسولين في مصل الصيام ومستويات HOMA-IR

≥ 4.64 نانوغرام / مل و ≥ 1.1، على التوالي، كمنبئات للحمل الإيجابي لدى النساء اللواتي يخضعن للحقن المجهري.

الاستنتاج: مقاومة الأنسولين أثرت سلباً على نتائج الحقن المجهري للنساء المصابات بالعقم. علاوة على ذلك، قد تزيد السمنة من مستوى مقاومة الأنسولين لدى النساء المصابات بالعقم. ووفقا لهذه النتائج، فإن تحسين HOMA-IR ومؤشر كتلة الجسم سيؤدي ببساطة إلى تحسين نتائج الحقن المجهري.

التنزيلات

بيانات التنزيل غير متوفرة بعد.

المراجع

Rahman MS, Hossain KS, Das S, Kundu S, Adegoke EO, Rahman MA, et al. Role of insulin in health and disease: An update. Int J Mol Sci. 2021;22(12):1-19. doi: 10.3390/ijms22126403.

Lee SH, Park SY, Choi CS. Insulin resistance: From mechanisms to therapeutic strategies. Diabetes Metab J. 2022;46(1):15-37. doi: 10.4093/dmj.2021.0280.

Wang H, Zhang Y, Fang X, Kwak-Kim J, Wu L. Insulin resistance adversely affect IVF outcomes in lean women without PCOS. Front Endocrinol (Lausanne). 2021;12:734638. doi: 10.3389/fendo.2021.734638.

Mohsin HAH, Mossa HAL, Jawad MA. The impact of serum and follicular fluid secreted frizzled-related protein-5 on ICSI outcome in Iraqi infertile women with different body mass index. Biomedicine. 2023;43(4):1239-1246. doi: 10.51248/.v43i4.3109.

Broughton DE, Moley KH. Obesity and female infertility: potential mediators of obesity’s impact. Fertil Steril. 2017;107(4):840-847. doi: 10.1016/j.fertnstert.2017.01.017.

Ahmed B, Sultana R, Greene MW. Adipose tissue and insulin resistance in obese. Biomed Pharmacother. 2021;137:111315. doi: 10.1016/j.biopha.2021.111315.

World Health Organization (WHO). Waist Circumference and waist–hip ratio. Report of a WHO expert consultation. Geneva, 8-11 December 2008:8–11. Available from: http://www.who.int

Hasan HA, Selman MO, Jwad MA. Effect of body mass index on serum CA125 level in females with PCOS. Iraqi J Embryos Infertil Res. 2020;10(1):101-118.

Yong W, Wang J, Leng Y, Li L, Wang H. Role of obesity in female reproduction. Int J Med Sci. 2023;20(3):366. doi: 10.7150/ijms.80189.

Zatterale F, Longo M, Naderi J, Raciti GA, Desiderio A, Miele C, et al. Chronic adipose tissue inflammation linking obesity to insulin resistance and type 2 diabetes. Front Physiol. 2020;10:1-20. doi: 10.3389/fphys.2019.01607.

Brown M, Dainty S, Strudwick N, Mihai AD, Watson JN, Dendooven R, et al. Endoplasmic reticulum stress causes insulin resistance by inhibiting delivery of newly synthesized insulin receptors to the cell surface. Mol Biol Cell. 2020;31(23):2597-2629. doi: 10.1091/mbc.E18-01-0013.

Wan Y, Muhammad T, Huang T, Lv Y, Sha Q, Yang S, et al. IGF2 reduces meiotic defects in oocytes from obese mice and improves embryonic developmental competency. Reprod Biol Endocrinol. 2022;20(1):1-13. doi: 10.1186/s12958-022-00972-9.

Paley CA, Johnson MI. Abdominal obesity and metabolic syndrome: Exercise as medicine? BMC Sports Sci Med Rehabil. 2018;10(1):1-8. doi: 10.1186/s13102-018-0097-1.

Yang T, Yang Y, Zhang Q, Liu D, Liu N, Li Y, et al. Homeostatic model assessment for insulin resistance is associated with late miscarriage in non-dyslipidemic women undergoing fresh IVF/ICSI embryo transfer. Front Endocrinol (Lausanne). 2022;13:1-11. doi: 10.3389/fendo.2022.880518.

Silvestris E, de Pergola G, Rosania R, Loverro G. Obesity as disruptor of the female fertility. Reprod Biol Endocrinol. 2018;16(1). doi: 10.1186/s12958-018-0336-z.

Hussam F, Khudair SA, Alkhafaje WK, Alnassar YS, Kaoud RM, Abed AN, et al. A Cross-sectional study regarding infertility among women in Iraq. J Obstet Gynecol Cancer Res. 2023;8(1):47-52.

World Obesity Federation. Obesity Classification. 2022 [cited 2023 Sep 18]. Available from: https://www.worldobesity.org/about/about-obesity/obesity-classification

Balaban B, Brison D, Calderón G, Catt J, Conaghan J, Cowan L, et al. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum Reprod. 2011;26(6):1270-1283. doi: 10.1093/humrep/der037.

Zhang Y, Li Z, Ren B, Wu W, Liu Y, Wang X, et al. Diagnostic value of a single β-hCG test in predicting reproductive outcomes in women undergoing cleavage embryo transfer: A retrospective analysis from a single center. Reprod Health. 2020;19:145. doi: 10.1186/s12978-022-01455-1.

Jain M, Singh M, (Eds.), Assisted Reproductive Technology (ART) Techniques, StatPearls Publishing; 2022. PMID: 35015434.

Nelson OE, Chukwuma EF. Association of body mass index with hypothalamus-pituitary-ovarian axis hormones in infertile women in the Niger Delta region, Nigeria. Open J Obstet Gynecol. 2022;12(08):671-685. doi: 10.4236/ojog.2022.128060.

Pengpid S, Peltzer K. Overweight and obesity among adults in Iraq: Prevalence and correlates from a national survey in 2015. Int J Environ Res Public Health. 2021;18(8):4198. doi: 10.3390/ijerph18084198.

Al-Yasiry RZ, Jwad MA, Hasan MF, Alsayigh HA. How obesity affects female fertility. Med J Babylon. 2022;19(2):111-114. doi: 10.4103/MJBL.MJBL_8_22.

Abd Ali A, Al-Hilli N, Jawad MA. Effect of obesity on ICSI outcome in Iraqi infertile females. Biochem Cell Arch. 2020;20(2):6383-6389.

Marinelli S, Napoletano G, Straccamore M, Basile G. Female obesity and infertility: outcomes and regulatory guidance. Acta Biomed. 2022;93(4):e2022278. doi: 10.23750/abm.v93i4.13466.

Ribeiro LM, Sasaki LMP, Silva AA, Souza ES, Oliveira Lyrio A, C M G Figueiredo A, et al. Overweight, obesity and assisted reproduction: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2022;271:117-127. doi: 10.1016/j.ejogrb.2022.01.019.

Fedorcsák P, Dale PO, Storeng R, Tanbo T, Åbyholm T. The impact of obesity and insulin resistance on the outcome of IVF or ICSI in women with polycystic ovarian syndrome. Hum Reprod. 2001;16(6):1086-1091. doi: 10.1093/humrep/16.6.1086.

Páez JCS, Arreseygor VG, Zgrablich P. Obesity and the possibility of conceiving a child during assisted reproduction treatment: An Argentinian experience. JBRA Assist Reprod. 2020;24(2):115. doi: 10.5935/1518-0557.20190064.

Dornelles VC, Hentschke MR, Badalotti M, Telöken IB, Trindade VD, Cunegatto B, et al. The impact of body mass index on laboratory, clinical outcomes and treatment costs in assisted reproduction: a retrospective cohort study. BMC Womens Health. 2022;22(1):479. doi: 10.1186/s12905-022-02036-x.

Ozekinci M, Seven A, Olgan S, Sakinci M, Keskin U, Akar ME, et al. Does obesity have detrimental effects on IVF treatment outcomes? BMC Womens Health. 2015;15:61. doi: 10.1186/s12905-015-0223-0.

Zeng R, Chen H, Zeng X, Qin L. The essential role of body weight in adjusting Gn dosage to prevent high ovarian response for women with PCOS during IVF: A retrospective study. Front Endocrinol (Lausanne). 2022;13:922044. doi: 10.3389/fendo.2022.922044.

Pandey S, Pandey S, Maheshwari A, Bhattacharya S. The impact of female obesity on the outcome of fertility treatment. J Hum Reprod Sci. 2010;3(2):62-67. doi: 10.4103/0974-1208.69332.

Hu D, Huang B, Xiong M, Yao J, Yang S, Wu R, et al. Impact of elevated body mass index on cumulative live birth rate and obstetric safety in women undergoing assisted reproductive technology. Sci Rep. 2022;12(1):18858. doi: 10.1038/s41598-022-23576-0.

Kumar M, Kaushik D, Kaur J, Proestos C, Oz F, Oz E, et al. A critical review on obesity: Herbal approach, bioactive compounds, and their mechanism. Appl Sci. 2022;12(16). doi: 10.3390/app12168342.

Leary C, Leese HJ, Sturmey RG. Human embryos from overweight and obese women display phenotypic and metabolic abnormalities. Hum Reprod. 2015;30(1):122-132. doi: 10.1093/humrep/deu276.

Comstock IA, Kim S, Behr B, Lathi RB. Increased body mass index negatively impacts blastocyst formation rate in normal responders undergoing in vitro fertilization. J Assist Reprod Genet. 2015;32(9):1299-1304. doi: 10.1007/s10815-015-0515-1.

Herrero J, Tejera A, Albert C, Vidal C, de los Santos MJ, Meseguer M. A time to look back: analysis of morphokinetic characteristics of human embryo development. Fertil Steril. 2013;100(6):1602-1609. doi: 10.1016/j.fertnstert.2013.08.033.

Keefe DL. Telomeres and genomic instability during early development. Eur J Med Genet. 2020;63(2):103638. doi: 10.1016/j.ejmg.2019.03.002.

Bosch E, Broer S, Griesinger G, Grynberg M, Humaidan P, Kolibianakis E, et al. ESHRE guideline: ovarian stimulation for IVF/ICSI†. Hum Reprod Open. 2020;2020(2):hoaa009. doi: 10.1093/hropen/hoaa009.

Pan XM, Lin Z, Li N, Wu JQ, Chen DQ, Zhu YM, et al. Effects of body mass index on the outcomes of in vitro fertilization in Chinese patients with polycystic ovary syndrome: a retrospective cohort study. J Zhejiang Univ Sci B. 2018;19(6):490-496. doi: 10.1631/jzus.B1800113.

Abdul Kareem NG, Jafer AK, Mahmood WT, Alkabban M. Evaluation of insulin resistance according to the obesity grades in Iraqi non-diabetic adults. Biochem Cell Arch. 2020;20(1):2157-2162.

Song H, Yu Z, Li P, Wang Y, Shi Y. HOMA-IR for predicting clinical pregnancy rate during IVF. Gynecol Endocrinol. 2022;38(1):33-38. doi: 10.1080/09513590.2021.1952976.

Raperport C, Chronopoulou E, Homburg R. Effects of metformin treatment on pregnancy outcomes in patients with polycystic ovary syndrome. Expert Rev Endocrinol Metab. 2021;16(2):37-47. doi: 10.1080/17446651.2021.1889366.

Ke J, Feng Y, Chen Z. Association between waist circumference and female infertility in the United States. PLoS One. 2023;18(12):e0295360. doi: 10.1371/journal.pone.0295360.

Khalaf Allah A, Elmekkawi S, Megahed A. Obesity index that better predict ovarian response: Body mass index, waist circumference, waist hip ratio, or waist height ratio in women undergoing ICSI: A pilot study. Evid Based Women’s Health J. 2020;10(1):54-64. doi: 10.21608/ebwhj.2019.18167.1040.