Impact of Central Obesity on Women with Polycystic Ovary Syndrome Undergoing Fertilization

Central obesity (CO) is a defining characteristic of polycystic ovary syndrome (PCOS) and PCOS-induced disorders are likely to be exacerbated in the presence of CO. This study aims to evaluate the impact of CO on infertile women with PCOS undergoing fertilization (IVF).It is a retrospective and case-control study. One hundred eighty-eight infertile PCOS women undergoing IVF were divided into CO group ( = 70, waist circumference [WC] ≥80 cm) and noncentral obesity (NCO) group ( = 118, WC <80 cm). Baseline characteristics, parameters of ovarian stimulation and laboratory, and pregnancy outcomes were compared between two groups. After controlling for body mass index (BMI), WC positively correlated with fasting insulin ( = 0.210,  = 0.007), homeostatic model assessment for insulin resistance ( = 0.249,  = 0.006) and free androgen index ( = 0.249,  = 0.006). Compared with NCO group, CO group had significantly increased endocrine and metabolic disorders and needed significantly higher dose of gonadotropins, longer duration of ovarian stimulation ( < 0.05), but had significantly lower peak serum estradiol level ( < 0.01) and less oocytes retrieved ( = 0.032). CO group had significantly lower live birth and implantation rates (53.8% vs. 86.8%,  = 0.001; and 24.3% vs. 36.3%,  = 0.019, respectively) and higher early spontaneous miscarriage rate (38.5% vs. 7.5%,  = 0.002). For the multivariate analysis, by adjusting for age, BMI, insulin resistance, and hyperandrogenism (HA), CO was significantly independent risk factor for early miscarriage (adjusted relative ratio = 16.87, 95% confidence interval = 2.15-132.70,  = 0.007). CO is associated with insulin resistance, hyperinsulinemia, and HA independent of BMI and is associated with poor pregnancy outcome in infertile women with PCOS undergoing IVF.