Increased prevalence of insulin resistance in women with a history of recurrent pregnancy loss

Objective: To determine whether insulin resistance is associated with recurrent pregnancy loss (RPL). Design: Single center, case-controlled, prospective study. Setting: University-associated reproductive endocrinology clinical practice. Patient(s): Seventy-four nonpregnant, nondiabetic women with RPL. Controls were 74 fertile, nonpregnant, nondiabetic women without RPL who had at least one live infant, and were matched by age, race, and body mass index (BMI). Intervention(s): Both groups consented to obtaining fasting insulin and glucose levels. Main Outcome Measure(s): Insulin resistance was defined as a fasting insulin level >20 muU/mL or a fasting glucose to insulin ratio of <4.5. Result(s): Among the 74 women with RPL, 20 (27.0%) demonstrated insulin resistance, whereas only 7 of 74 (9.5%) of the matched controls were insulin resistant (odds ratio 3.55; 95% confidence interval 1.40-9.01). The RPL and control groups were similar with respect to age, ethunicity, and BMI. The RPL and control groups had similar fasting glucose levels and glucose-to-insulin ratios. However, fasting insulin levels greater than or equal to20 muU/mL were statistically different between the two groups (odds ratio 3.92). Conclusion(s): Women with RPL have a significantly increased prevalence of insulin resistance when compared with matched fertile controls. (C) 2002 by American Society for Reproductive Medicine.