Endocrine Abstracts

Objective: Obese PCOS have poor IVF outcomes. The aim of this study was to evaluate the impact of weight reduction with metformin alone or in adjunct with liraglutide on oocyte maturity and embryo quality in infertile obese PCOS population.

Design/participants/main outcome measure: A 12-week prospective randomized study was conducted with 40 infertile PCOS (30.77±3.742 aged years, BMI 36.69±3.51 kg/m², mean ± SD) who had been previously poor responders to lifestyle intervention. They were assigned to metformin (MET) 1000 mg BID or MET 1000 mg BID and liraglutide 1.2 mg QD S.C. (COMBI) or to controls (CON). CON direclty proceeded with ovarian stimulation protocol, whereas MET and COMBI started with stimulation after 4 weeks medication free period.

Results: Eleven women on MET, 13 on COMBI and 11 CON completed the study. Patients in MET lost 6.70±6.70 kg (P?0.001) compared with 7.68±3.74 kg loss in COMBI (P<0.001), COMBI not being superior to MET (P=0.103). COMBI resulted in a reduction of visceral adipose tissue area (−20.65±7.40 cm²; P=0.028). More than 5% of weight reduction was achieved in 76.9% in COMBI and 45.5% of patients in MET. In high responders who lost more than 5% of body weight numbers of blastocysts/patient were greater in both treatment arms than in CON (3.67±4.82 in COMBI; 3.60±6.95 in MET; vs 2.09±2.07 in CON). High responders in COMBI had the highest numbers of oocytes/patient 14.67±9.59 and of mature oocyte 11.22±9.27 (P=NS). In COMBI 3 patients became spontaneously pregnant before IVF in medication free period.

Conclusion: Women who lost more than 5% of body weight before IVF had increased fertility potential. COMBI resulted in the highest number of high responders and was associated with the highest number of blastocysts/patient. The high rate of spontaneous pregnancies in COMBI implies the potential role of GLP-1 in reproduction.