Impact of hyperuricemia on the clinical outcomes in patients with polycystic ovary syndrome undergoing in vitro fertilization and embryo transfer
Objective To investigate the impact of hyperuricemia on the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle in patients with polycystic ovary syndrome(PCOS)undergoing in vitro fertilization and embryo transfer(IVF-ET).Methods A retrospective cohort study was conducted on data from 3 959 PCOS patients who received IVF-ET treatment at the Reproductive Centers of Henan Provincial People's Hospital and Jiangxi Provincial Maternal and Child Health Hospital between January 2016 and December 2021.The patients were divided into hyperuricemia group(>357 μmol/L,n=1 126)and normal uric acid group(≤357 μmol/L,n=2 833)based on their uric acid levels.Baseline data,clinical and laboratory indicators were compared between the two groups.Univariate and multivariate regression analyses were performed on factors influencing clinical outcomes.Multivariate logistic regression analysis was used to compare the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle between the two groups,clarifying the impact of hyperuricemia on clinical outcomes in PCOS patients.Results There were no significant differences between the two groups in terms of age,duration of infertility,baseline testosterone level,type of infertility,and the rate of unusable embryos(all P>0.05).Body mass index[BMI,(25.15±3.75)kg/m2],fasting blood glucose[(4.99±0.80)mmol/L]and fasting insulin levels[17.19(11.78,25.30)mU/L]in hyperuricemia group were higher than those in normal uric acid group[(23.60±3.64)kg/m2,P<0.001;(4.88±0.81)mmol/L,P<0.001;12.40(8.59,17.86)mU/L,P<0.001],while their baseline luteinizing hormone[7.62(4.68,11.18)U/L]and anti-Müllerian hormone[7.62(5.34,10.73)μg/L]levels were lower than those in normal uric acid group[7.88(4.98,11.91)U/L,P=0.024;7.95(5.49,11.73)μg/L,P<0.001],with statistically significant differences.Multivariate logistic regression analysis indicated that female BMI,endometrial thickness on human chorionic gonadotropin(hCG)injection day,and the number of transferable embryos were factors influencing the live birth rate per transfer cycle(OR=1.02,95%CI:1.00-1.04,P=0.044;OR=0.95,95%CI:0.92-0.97,P<0.001;OR=0.97,95%CI:0.95-0.99,P=0.006).Fasting blood glucose,endometrial thickness on hCG injection day,and the number of transferable embryos were factors influencing the cumulative live birth rate per oocyte retrieval cycle(OR=1.14,95%CI:1.01-1.29,P=0.036;OR=0.92,95%CI:0.87-0.97,P=0.002;OR=0.70,95%CI:0.66-0.75,P<0.001).Compared with the normal uric acid group,the hyperuricemia group in PCOS patients had not a statistically signifcant decrease in the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle(OR=0.93,95%CI:0.72-1.19,P=0.548;OR=1.18,95%CI:0.87-1.60,P=0.300).Conclusion Hyperuricemia does not affect the live birth rate per transfer cycle or the cumulative live birth rate per oocyte retrieval cycle in PCOS patients undergoing IVF-ET.
Uric acidFertilization in vitroEmbryo transferPolycystic ovary syndromeLive birth rateCumulative live birth rate
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