The effect of serum and intrafollicular insulin resistance parameters and homocysteine levels of nonobese, nonhyperandrogenemic polycystic ovary syndrome patients on in vitro fertilization outcome.

OBJECTIVE: To investigate the serum and follicular fluid concentrations of insulin resistance parameters and homocysteine and their effect on IVF outcome in nonobese, nonhyperandrogenemic polycystic ovary syndrome patients.
DESIGN: Prospective study.
SETTING: Department of Infertility of Dr. Zekai Tahir Burak Women's Health Research and Education Hospital. PATIENT(S): Ninty-seven women underwent IVF. INTERVENTION(S): Subjects were categorized according to IVF indications: group 1 with polycystic ovary syndrome (PCOS), group 2 with subfertile male partners, group 3 with unexplained infertiliy. Serum and follicular fluid parameters from the first follicle on the day of oocyte retrieval were analyzed. MAIN OUTCOME MEASURE(S): Serum and follicular fluid insulin resistance parameters, homocysteine, sex hormone levels, and laboratory and clinical IVF outcome were studied. RESULT(S): Serum insulin, homeostasis model assessment estimate of insulin resistance (HOMA-IR), and homocysteine levels were significantly higher in subjects having PCOS. However, these significant differences in serum insulin resistance and homocysteine levels were not seen in the follicular microenvironment. There were no differences in clinical pregnancy rates between study groups. CONCLUSION(S): Despite elevated serum insulin, HOMA-IR, and homocysteine levels, and their effects on oocyte numbers and maturation in PCOS patients, there were no differences in follicular parameters and clinical pregnancy rates between hyperinsulinemic and hyperhomocysteinemic PCOS patients and the other two groups. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.