In Vitro Fertilization Impact on Metabolic Parameters
Condition: GDM; Insulin Resistance; Glucose Intolerance; PCOS; Obesity
MeSH terms: Insulin Resistance; Glucose Intolerance
Study type: Observational [Patient Registry]

Summary: 
      A quantitative prospective cohort study will be conducted, where blood samples will be
      collected at different timings during the IVF protocol, to assess the impact of fertility
      medications on metabolic parameters of patients undergoing IVF treatment.
    

Detailed description: 
      Numerous factors predispose women to develop pregnancy-related complications, these include
      gestational diabetes (GDM), pre-pregnancy obesity, advanced maternal age (> 35 years) and
      gestational age, abnormal weight gain during pregnancy, family history of diabetes, PCOS and
      low parity. Evidenced-based studies reported that women with PCOS have a significantly higher
      risk of developing GDM compared with women without PCOS, independently of the obesity factor;
      this risk is higher when both factors coexist.

      Given the known effect of reproductive hormones on weight-gain, controversies still exist on
      whether ART predispose women to more adverse obstetric outcomes compared to normal pregnancy.
      ART describes different procedures to help women become pregnant, with In Vitro Fertilization
      (IVF) being the most commonly performed. It has been demonstrated that IVF is associated with
      glucose intolerance in mice and it will be interesting to determine whether this physiologic
      phenomenon is also altered by IVF medication (such as estrogen and progesterone) in humans.
      While some studies reported that singleton pregnancies conceived by ART (IVF or ovulation
      induction) were strongly associated with GDM compared to spontaneous conceptions, other
      studies did not find significant differences in the risk of GDM. Increased GDM risk presented
      with IVF can be associated with prenatal obesity or secondary to maternal PCOS condition. The
      former studies did not specify the body mass index (BMI) and the medical history of
      participants undergoing IVF, such as the presence of PCOS. Due to limited available data, we
      still cannot distinguish whether these adverse pregnancy outcomes are due to the pre-existing
      conditions such as PCOS, or are secondary to the IVF therapy itself.
    

Intervention name(s): HbA1C
Intervention type(s): Diagnostic Test
Intervention description(s): After overnight fasting, 10 ml of blood will be collected at four different timings during the IVF protocol:
At baseline (second day of the menstrual period)
Triggering phase (post-egg retrieval procedure)
Embryo transfer phase (post-transfer procedure)
Week 4 (positive bHCG)
4. Week 8 of pregnancy
Other intervention name(s): Lipid profile; Hormonal profile: FSH, LH, progesterone, estrogen,Beta-HCG; Serum Insulin level; Fasting Glucose level; Thyroid-Stimulating Hormone
Intervention MeSH terms: Progesterone; Estrogens
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        A convenience sample from adult women of < 39 years of age undergoing fresh IVF treatment
        at Fakih IVF Clinic in Dubai will be chosen. Participants who will fulfill the inclusion
        criteria will be recruited.
      
Keywords: IVF, Glucose Homeostasis, Metabolic Parameters