Abnormal preconception oral glucose tolerance test predicts an unfavorable pregnancy outcome after an in vitro fertilization cycle.
OBJECTIVE
To determine the relationship between the 75-g oral glucose tolerance test and pregnancy outcome after women's first IVF cycle.


METHODS
Prospective study.


METHODS
Infertility center at a private tertiary hospital in Taiwan.


METHODS
All 280 patients who went through their initial IVF cycle at the hospital between January 2004 and April 2005 were included in the study.


METHODS
Two hundred eighty patients underwent an oral glucose tolerance test before entering an IVF cycle; all pregnancy outcomes and pregnancy complications were recorded.


METHODS
The relationships between glycemic parameters and insulin resistance and IVF pregnancy outcome were determined. Linear regression between birth weight and levels of preconception fasting insulin, 2-hour glucose, and 2-hour insulin was performed.


RESULTS
One hundred twenty patients conceived after their initial IVF cycle. Twenty-five of 89 ongoing pregnancies had various complications. The most common pregnancy complication was preterm birth (n = 11). These patients had higher body mass index (23.46 vs. 20.97 kg/m(2)); higher fasting glucose (107.36 vs. 95.14 mg/dL), fasting insulin (10.55 vs. 6.20 microIU/mL), and 2-hour glucose (120.55 vs. 99.97 mg/dL) levels; and higher homeostatic model assessment of insulin resistance (3.43 vs. 1.45) than did patients with full-term pregnancies. Linear regression between birth weight and the fasting glucose level and between birth weight and the homeostatic model assessment of insulin resistance had positive correlations.


CONCLUSIONS
Before proceeding with IVF, preconception oral glucose tolerance testing is suggested, especially in patients with higher body mass index, to help identify groups who are at high risk for preterm birth.
Wei
Hsiao-Jui
HJ
Graduate Institute of Medical Science, Taipei Medical University, Taipei, Taiwan.
Young
Robert
R
Kuo
I-Li
IL
Liaw
Chian-Mey
CM
Chiang
Han-Sun
HS
Yeh
Ching-Ying
CY
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D005951:Glucose Tolerance Test / Q000706:statistics & numerical data*; D006801:Humans; D006946:Hyperinsulinism / Q000175:diagnosis* / Q000453:epidemiology*; D015994:Incidence; D016742:Preconception Care / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology