HOW INSULIN RESISTANCE IN POLYCYSTIC OVARY SYNDROME AFFECTS THE EMBRYO IMPLANTATION PROCESS
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i1.15242Keywords:
infertility, polycystic ovary syndrome, metabolic syndrome, embryo implantation, pregnancy, reproductive losses, insulin resistance, hormonesAbstract
SUMMARY. Infertility is one of the main problems of reproductive medicine, in particular in women with polycystic ovary syndrome (PCOS), which is accompanied by insulin resistance and metabolic disorders that negatively affect ovulation, oocyte quality and endometrial implantation capacity. Assisted reproductive technologies, in particular IVF, are the main methods of treatment for such patients, but their effectiveness is often reduced due to the impaired endometrial receptivity.
The aim – to analyze the effect of metabolic disorders in PCOS on embryo implantation, in particular through hormonal and inflammatory mechanisms, based on modern scientific research.
Material and Methods. We analyzed scientific publications from PubMed, Scopus, Web of Science, and Google Scholar databases over the past 10 years. Peer-reviewed articles covering the molecular mechanisms of insulin resistance, changes in the endometrial microenvironment and their impact on implantation were selected.
Results. Embryo implantation is a complex process that depends on the coordinated interaction of the endocrine, immune and vascular systems, as well as the receptivity of the endometrium. In polycystic ovary syndrome, implantation disorders are caused by hormonal imbalance, insulin resistance, angiogenesis defects, and chronic inflammation, which reduces the likelihood of successful embryo attachment; additionally, metabolic syndrome impairs endometrial receptivity due to oxidative stress and impaired immune tolerance. Randomized trials and meta-analyses showed that not only the qualitative characteristics of the embryo, but also adequate correction of implantation disorders in PCOS and individualized approaches to endometrial preparation before implantation in IVF programs are key factors in the success of infertility treatment in this cohort of patients.
Conclusions. A multifactorial approach to the treatment of infertility in patients with PCOS and metabolic syndrome includes lifestyle correction, metabolic and antioxidant therapy, which helps to improve hormonal balance, folliculogenesis and endometrial receptivity. A personalized approach to determining the implantation window and the use of the endometrial receptivity analysis (ERA) test can increase the effectiveness of IVF, reducing the risk of failed implantations.
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