Effects of dysregulated glucose metabolism on the occurrence and ART outcome of endometriosis

Jianpeng Chen, Yanye Zhang, Jiani Jin, Yue Ying, Zhi-Min Song, Mixue Tu, Xiaohang Ye, Huanna Tang, Fei-Da Ni, Yanyun Ying, Juan Liu, Jingyi Li, Dan Zhang
In: Research Square · 2023 · doi:10.21203/rs.3.rs-2750434/v1 · W4361989618
preprint OA: green CC0
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Endometriosis patients exhibit abnormal metabolic indexes, with serum glucose and insulin levels linked to disease occurrence, oocyte retrieval, and GDM, and a prediction model incorporating these factors shows promise for non-invasive diagnosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective cohort study analyzed 412 infertility patients with laparoscopically confirmed endometriosis and 1,551 control patients with tubal-factor infertility who underwent IVF/ICSI between 2019 and 2020, comparing systemic metabolic indexes (including fasting glucose and insulin) measured before ART and their associations with endometriosis occurrence and ART outcomes. Endometriosis patients had higher serum insulin levels, and a prediction model combining pregnancy history, CA125, fasting glucose, and insulin showed moderate discrimination (AUC ~0.77) for identifying endometriosis. The study found no significant differences in ART outcomes or complications between groups, while glucose was associated with gestational diabetes mellitus in both endometriosis and control groups. Limitations include its preprint status (not peer reviewed) and the exclusion of multiple metabolic and endocrine disorders to reduce confounding. This paper is centrally about endometriosis — it evaluates dysregulated glucose/insulin metabolism as a marker for endometriosis occurrence and examines how metabolic indicators relate to ART outcomes and GDM in endometriosis patients.

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Abstract

Abstract Background: Endometriosis can affect the systemic metabolic indicators, including body mass index, glucose metabolism and lipid metabolism, while the association between metabolic indexes and the occurrence and ART outcome of endometriosis is unclear. We aimed to evaluate the characteristics of systemic metabolic indexes of endometriosis patients with infertility and their effects on pregnancy outcome after ART treatment. Methods: A retrospective cohort study involve 412 endometriosis patients and 1551 controls was conducted. Primary outcome was metabolic indexes, and secondary measures consisted of the influence of metabolic indexes on the number of retrieved oocytes and ART outcomes, as well as the relation between blood glucose and prevalence of GDM. Results: Endometriosis patients had higher INS [6.90(5.10-9.50) vs 6.50(4.80-8.90) μU/mL, P = 0.005]. A prediction model for endometriosis combining the number of previous pregnancies, CA125, fasting blood Glu and INS, had a sensitivity of 73.9%, specificity of 67.8% and area AUC of 0.77. There were no significant differences in ART outcomes and complications. The levels of Glu were associated with GDM both in endometriosis group (aOR 12.95, 95% CI 1.69–99.42; P = 0.014) and in control group (aOR 4.15, 95% CI 1.50–11.53; P = 0.006). Conclusions: Endometriosis patients had abnormal metabolic indexes, in which serum Glu and serum INS are related to the occurrence of endometriosis, the number of retrieved oocytes and the occurrence of GDM. A prediction model based on metabolic indexes was established, representing a promising non-invasive method to predict endometriosis patients with known pregnancy history.

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endometriosisinfertility

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