Influence of serum uric acid levels on pregnancy outcomes in patients with frozen-thawed embryo transfer
Objective To investigate the influence of serum uric acid level on the pregnancy outcome of frozen-thawed embryo transfer(FET).Methods This study was a retrospective cohort study.Patients were recruited underwent the first FET cycles at the Reproductive Medicine Center of Affiliated Hospital of Nantong University from January 2017 to June 2022.According to uric acid>340 μmol/L or not,the patients were divided into high uric acid group(n=157)and control group(n=899).Propensity score matching(PSM)and multivariate logistic regression analysis were conducted to screen the risk factors for adverse pregnancy outcomes.Results Patients in high uric acid group had a higher proportion of overweight[60.5%(95/157)],higher level of anti-Müllerian hormone[4.59(3.23,6.32)μg/L]and antral follicle count[21(15,28)]compared with control group[13.2%(119/899),P<0.001;4.46(2.51,5.27)μg/L,P= 0.024;19(12,25),P=0.003],and lower levels of basic follicle-stimulating hormone[(6.73±2.04)U/L]and estradiol on transformation day[232.97(147.13,358.40)pmol/L]compared with control group[(7.42±2.29)U/L,P<0.001;285.80(189.11,393.52)pmol/L,P=0.001].The abortion rate was higher[43.7%(38/87)]and the live birth rate was lower[31.2%(49/157)]in high uric acid group than in control group[23.6%(120/509),P<0.001;43.3%(389/899),P=0.005].After PSM,the abortion rate was significantly higher in high uric acid group as far[43.7%(38/87)]than in control group[23.0%(17/74),P=0.006],and high uric acid greatly increased the abortion rate in FET patients before and after PSM(before PSM:OR=2.193,95%CI:1.301-3.697,P=0.003;after PSM:OR=3.482,95%CI:1.620-7.483,P=0.001).Conclusion High level of uric acid before the pregnancy is an important risk factor for abortion in FET cycles,and controlling uric acid levels prior to conducting FET may decrease the abortion rate.
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