Effect of serum uric acid level on reproductive outcome in women without polycystic ovary syndrome undergoing in vitro fertilization.

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Leizhen Xia, Lu Fan, Jialyu Huang, Yan Zhao, Lifeng Tian, Houyang Chen, Li Cai, Qiongfang Wu, Leixiang Xia
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引用次数: 0

Abstract

Background: Prior research showed that elevated serum uric acid (SUA) levels in women with polycystic ovary syndrome (PCOS) before in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) treatment can lead to a lower rate of live birth and an increased risk for low birthweight. Nonetheless, it is not known whether elevated SUA results in similar reproductive outcome in women without PCOS. This study aimed to exploring the relationship between pre-pregnancy SUA levels and reproductive outcomes in non-PCOS women undergoing IVF/ICSI treatment.

Methods: This single-center, retrospective study included 13,325 women without PCOS undergoing their first IVF/ICSI fresh embryo transfer cycles from January 2014 to December 2022 at a university-affiliated reproductive medicine center in China. The trends for pregnancy, obstetric and perinatal outcomes across quartiles of SUA levels were assessed. A logistic regression analysis was applied to control for baseline and cycle characteristics. Generalized addition model was used to draw spline smoothing plot.

Results: There was no significant decreasing or increasing trend in the clinical pregnancy rate and live birth rate with the increase in quartiles of SUA levels. For Obstetric and perinatal outcomes following a single live birth, the percentage of hypertensive disorders in pregnancy (1.6-4.1%, Ptrend<0.001), gestational diabetes mellitus (5.9-13.9%, Ptrend<0.001), premature rupture of membranes (0.6-1.5%, Ptrend=0.016), preterm birth (6.3-9.2%, Ptrend=0.009), macrosomia (2.3-5.5%, Ptrend<0.001), large for gestational age (10.8-14.9%, Ptrend=0.002) all increased significantly from the lowest quartile to the highest. Logistic regression results showed that compared with those in quartile 1, the risk of maternal and infant complications mentioned above was still significantly higher in quartile 4 after adjusting for reproductive related factors. When further confounding factors were added, including body mass index (BMI), blood pressure, fasting blood glucose, and blood lipids related indicators, only gestational diabetes mellitus and macrosomia showed a significant increase.

Conclusion: In women without PCOS, SUA levels before IVF/ICSI treatment do not affect the probabilities of clinical pregnancy and live birth. An elevated SUA level is associated with an increased risk for hypertensive disorders in pregnancy, gestational diabetes mellitus, premature rupture of membranes, preterm birth, macrosomia, and large for gestational age. For gestational diabetes mellitus and macrosomia, the association is independent of BMI, blood pressure, blood glucose, and blood lipid.

血清尿酸水平对接受体外受精的无多囊卵巢综合征妇女生殖结果的影响。
背景:先前的研究表明,患有多囊卵巢综合症(PCOS)的妇女在接受体外受精或卵胞浆内单精子显微注射(IVF/ICSI)治疗前血清尿酸(SUA)水平升高,会导致活产率降低,低出生体重风险增加。然而,SUA升高是否会导致无多囊卵巢综合症的女性出现类似的生殖结果,目前尚不清楚。本研究旨在探讨接受体外受精/卵胞浆内单精子显微注射(IVF/ICSI)治疗的非多囊卵巢综合征女性孕前 SUA 水平与生殖结局之间的关系:这项单中心回顾性研究纳入了2014年1月至2022年12月在中国一所大学附属生殖医学中心接受首次IVF/ICSI新鲜胚胎移植周期的13325名非多囊卵巢综合征女性。研究评估了不同SUA水平四分位数的妊娠、产科和围产期结局趋势。采用逻辑回归分析控制基线和周期特征。采用广义加和模型绘制曲线平滑图:结果:随着 SUA 水平四分位数的增加,临床妊娠率和活产率没有明显的下降或上升趋势。就单胎活产后的产科和围产期结果而言,妊娠期高血压疾病(1.6%-4.1%,Ptrendtrend=0.016)、早产(6.3%-9.2%,Ptrend=0.009)和巨大儿(2.3%-5.5%,Ptrendtrend=0.002)的比例均从最低四分位数到最高四分位数显著增加。逻辑回归结果显示,与四分位数 1 相比,在调整了生殖相关因素后,四分位数 4 出现上述母婴并发症的风险仍明显较高。如果再加上其他混杂因素,包括体重指数(BMI)、血压、空腹血糖和血脂相关指标,只有妊娠糖尿病和巨大儿的风险会显著增加:对于无多囊卵巢综合征的妇女,体外受精/卵胞浆内单精子显微注射治疗前的 SUA 水平不会影响临床妊娠和活产的概率。SUA 水平升高与妊娠高血压、妊娠糖尿病、胎膜早破、早产、巨大儿和胎龄过大的风险增加有关。妊娠糖尿病和巨大儿与体重指数、血压、血糖和血脂无关。
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来源期刊
Reproductive Biology and Endocrinology
Reproductive Biology and Endocrinology 医学-内分泌学与代谢
CiteScore
7.90
自引率
2.30%
发文量
161
审稿时长
4-8 weeks
期刊介绍: Reproductive Biology and Endocrinology publishes and disseminates high-quality results from excellent research in the reproductive sciences. The journal publishes on topics covering gametogenesis, fertilization, early embryonic development, embryo-uterus interaction, reproductive development, pregnancy, uterine biology, endocrinology of reproduction, control of reproduction, reproductive immunology, neuroendocrinology, and veterinary and human reproductive medicine, including all vertebrate species.
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