Reproductive Medicine Center, Xiangya Hospital of Central South University, Changsha Hunan, P.R. China; Clinical Research Center for Women's Reproductive Health in Hunan Province, Changsha Hunan, P.R. China.
Reproductive Medicine Center, Xiangya Hospital of Central South University, Changsha Hunan, P.R. China; Clinical Research Center for Women's Reproductive Health in Hunan Province, Changsha Hunan, P.R. China.
Reprod Biomed Online. 2021 Dec;43(6):1095-1105. doi: 10.1016/j.rbmo.2021.08.030. Epub 2021 Oct 26.
Are there associations between dyslipidaemia and pregnancy outcomes in the first complete cycle of IVF/intracytoplasmic sperm injection (ICSI)?
This long-term, retrospective real-world analysis involved 5030 infertile women who underwent a first complete IVF/ICSI cycle between January 2015 and October 2020. They were categorized into dyslipidaemia (n = 1903) and control (n = 3127) groups according to serum lipid concentrations before ovarian stimulation. Propensity score matching and multivariable logistic regression were used to control for confounding variables.
In the raw cohort, women with dyslipidaemia had a significantly increased late miscarriage rate (P = 0.039), decreased term birth rate (P = 0.002) and decreased live birth rate (P = 0.005) compared with non-dyslipidaemic women. In the propensity score-matched cohort, the term birth rate (P = 0.038) and live birth rate (P = 0.044) were significantly lower in the dyslipidaemia group (n = 1686) than the controls (n = 1686). Multivariable logistic regression indicated that infertile women with dyslipidaemia (P = 0.026) and elevated serum total cholesterol concentrations (total cholesterol ≥5.20 mmol/l; P = 0.028) were significantly less likely to have a live birth. Rates of late miscarriage (P = 0.027), term birth (P = 0.003) and live birth (P = 0.010) differed significantly among women with normal, borderline increased and increased serum lipid concentrations. Compared with controls, women with increased serum lipid concentrations had a significantly higher late miscarriage rate, lower term birth rate and lower live birth rate. Women with increased serum lipid concentrations were significantly less likely than controls to have a live birth.
Dyslipidaemia, total cholesterol ≥5.20 mmol/l and degrees of elevated serum lipid concentrations are negatively associated with live birth rate in the first complete IVF/ICSI cycle in infertile women.
在体外受精/胞浆内单精子注射（ICSI）的第一个完整周期中，血脂异常与妊娠结局之间是否存在关联？
这项长期的回顾性真实世界分析涉及 5030 名接受 2015 年 1 月至 2020 年 10 月期间第一次完整 IVF/ICSI 周期的不孕女性。根据卵巢刺激前的血清脂质浓度，她们被分为血脂异常组（n=1903）和对照组（n=3127）。采用倾向评分匹配和多变量逻辑回归控制混杂因素。
在原始队列中，与非血脂异常的女性相比，血脂异常的女性晚期流产率显著升高（P=0.039），足月产率降低（P=0.002），活产率降低（P=0.005）。在倾向评分匹配队列中，血脂异常组（n=1686）的足月产率（P=0.038）和活产率（P=0.044）显著低于对照组（n=1686）。多变量逻辑回归表明，血脂异常（P=0.026）和血清总胆固醇浓度升高（总胆固醇≥5.20mmol/l；P=0.028）的不孕女性活产的可能性显著降低。晚期流产率（P=0.027）、足月产率（P=0.003）和活产率（P=0.010）在血清脂质浓度正常、边缘升高和升高的女性中差异显著。与对照组相比，血清脂质浓度升高的女性晚期流产率、足月产率和活产率均显著降低。与对照组相比，血清脂质浓度升高的女性活产的可能性显著降低。
血脂异常、总胆固醇≥5.20mmol/l 和血清脂质浓度升高程度与不孕妇女第一次完整 IVF/ICSI 周期的活产率呈负相关。
