Cardiometabolic profile worsens after failed IVF therapy
Click Here to Manage Email Alerts
A cohort of healthy women who underwent unsuccessful in vitro fertilization experienced increases in fasting glucose and insulin at 12 weeks that were not observed among similar women who became pregnant, study data show.
“IVF hormonal therapy impairs glucose, insulin and lipids; it is hence important to monitor metabolic and endocrine parameters, particularly with repeated and failed IVF cycles,” Ayla Coussa, PhD, MSc, RD, a clinical researcher and registered dietitian with the division of biomedical sciences at University of Warwick Medical School, Coventry, United Kingdom, told Healio.
In a prospective, observational study, Coussa and colleagues analyzed data from 275 healthy women recruited from three IVF clinics in the United Arab Emirates (median age, 32 years; median BMI, 25.4 kg/m²), including 158 women with IVF-conceived pregnancies and 117 for whom IVF therapy failed. Researchers followed participants for 12 weeks of their first IVF cycle, with women providing fasting blood samples at baseline and 12 weeks to assess reproductive hormones, fasting plasma glucose, serum insulin, HbA1c, lipid profile, thyroid-stimulating hormone and homeostatic model assessment of insulin resistance (HOMA-IR). The primary outcome of the study was change in glucose homeostasis in response to IVF therapy and during IVF-conceived pregnancy.
Researchers found that at 12 weeks, nonpregnant women experienced an increase from baseline in fasting glucose (mean, 86.04 mg/dL to 87.62 mg/dL), insulin (mean, 8.72 IU/mL to 9.37 IU/mL), HOMA-IR (mean, 1.9 to 2.1), total cholesterol (mean, 169.5 mg/dL to 174.9 mg/dL), triglycerides (mean, 71 mg/dL to 83.7 mg/dL) and HDL cholesterol (mean, 52 mg/dL to 54.11 mg/dL; P < .001 for all comparisons).
At 12 weeks, pregnant women experienced increases from baseline in total cholesterol (mean, 177.5 mg/dL to 199.5 mg/dL), triglycerides (mean, 73.5 mg/dL to 126.78 mg/dL) and HDL cholesterol (mean, 55.3 mg/dL to 65.1 mg/dL); however, pregnant women also experienced a reduction in fasting glucose (mean, 86.15 mg/dL to 82.19 mg/dL), HbA1c (mean, 5.3% to 5.08%) and TSH (mean, 1.71 IU/mL to 1.36 IU/mL) levels from baseline.
“Improvement of glucose homeostasis, decrease in thyroid profile, as well as increase in lipid profile in clinical pregnancy are likely a pregnancy-related effect,” the researchers wrote. “Neither adiponectin nor lipopolysaccharide-binding protein are affected by IVF therapies and during early IVF-conceived pregnancy. Hence, monitoring of metabolic and endocrine parameters in 3 months following IVF should be implemented in clinical practice, particularly with repeated and failed IVF attempts.”
Going forward, Coussa said researchers should compare metabolic parameters among women who conceived spontaneously vs. by IVF to assess the magnitude of change.
For more information:
Ayla Coussa, PhD, MSc, RD, can be reached at Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom; email: a.coussa@warwick.ac.uk
Collapse
Read more about
Click Here to Manage Email Alerts