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J Clin Endocrinol Metab. 2017 Oct 1;102(10):3822-3829. doi: 10.1210/jc.2017-01294.

Effect of Preconception Impaired Glucose Tolerance on Pregnancy Outcomes in Women With Polycystic Ovary Syndrome.

Wei D1,2,3, Zhang B4, Shi Y1,2,3, Zhang L1,2,3, Zhao S1,2,3, Du Y5, Xu L5, Legro RS6, Zhang H7, Chen ZJ1,2,3.

Author information

Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250001, China.
Key Laboratory of Reproductive Endocrinology, Shandong University, Ministry of Education, Jinan 250001, China.
National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan 250001, China.
Center for Reproductive Medicine, Maternal and Child Health Hospital in Guangxi, Nanning 530003, China.
Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200000, China.
Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, Pennsylvania 17033.
Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut 06520.



Women with polycystic ovary syndrome (PCOS) commonly have intrinsic insulin resistance and are recommended to undergo an oral glucose tolerance test (OGTT) for diabetes screening. However, the effect of preconception impaired glucose tolerance (IGT) on pregnancy is still unclear.


To prospectively assess the effect of preconception IGT on pregnancy outcomes.

Design, Setting, Patients, Interventions, and Main Outcome Measures:

This was a secondary analysis of a multicenter randomized trial in 1508 women with PCOS comparing live birth and obstetric complications between fresh and frozen embryo transfer. At baseline, fasting and 2-hour glucose and insulin levels after 75-g OGTT were measured.


Women with preconception IGT had higher risks of gestational diabetes in both singleton pregnancy [9.5% vs 3.2%; odds ratio (OR) 3.13; 95% confidence interval (CI) 1.23to 7.69] and twin pregnancy (20.0% vs 3.2%; OR 7.69; 95% CI 2.78 to 20.00) than women with normoglycemia. Preconception IGT was associated with a higher risk of large for gestational age in singleton newborns compared with normoglycemia (34.7% vs 19.8%; OR 2.13; 95% CI 1.19 to 3.85) or isolated impaired fasting glucose (i-IFG) (34.7% vs 15.4%; OR 2.94; 95% CI 1.33 to 6.25). Women with preconception IGT had a higher singleton pregnancy loss rate than women with i-IFG (31.4% vs 17.5%; OR 2.17; 95% CI 1.11 to 4.17). After adjusting for age, body mass index, duration of infertility, total testosterone level, and treatment groups (frozen vs fresh embryo transfer), these associations remained.


Preconception IGT, independent from BMI, was associated with adverse pregnancy outcome compared with i-IFG and normoglycemia.


[Indexed for MEDLINE]

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