Research question

Are there associations between dyslipidaemia and pregnancy outcomes in the first complete cycle of IVF/intracytoplasmic sperm injection (ICSI)?

Design

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.

Results

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.

Conclusions

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.

中文翻译：

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IVF/ICSI 第一个完整周期中血脂异常与妊娠结局之间的关联：真实世界分析

研究问题

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？

设计

这项长期的、回顾性的真实世界分析涉及 5030 名在 2015 年 1 月至 2020 年 10 月期间接受了第一个完整 IVF/ICSI 周期的不孕女性。根据以下标准，她们被分为血脂异常组 ( n  = 1903) 和对照组 ( n  =  3127)卵巢刺激前的血脂浓度。倾向得分匹配和多变量逻辑回归用于控制混杂变量。

结果

在原始队列中，与非血脂异常女性相比，血脂异常女性的晚期流产率（P  =  0.039）、足月出生率（P  =  0.002）和活产率（P  =  0.005）显着增加。在倾向得分匹配队列中，血脂异常组（ n =  1686）的足月出生率（P  =  0.038）和活产率（P  =  0.044）显着低于对照组（ n =  1686）。多变量logistic回归表明不孕女性血脂异常（P =    0.026）和升高的血清总胆固醇浓度（总胆固醇≥5.20 mmol/l；P  =  0.028）显着降低活产的可能性。晚期流产 ( P  =  0.027)、足月分娩 ( P  =  0.003) 和活产 ( P  =  0.010) 的发生率在血脂浓度正常、临界升高和升高的女性中存在显着差异。与对照组相比，血清脂质浓度升高的女性晚期流产率、足月出生率和活产率显着升高。与对照组相比，血清脂质浓度升高的女性活产的可能性显着降低。

结论

血脂异常、总胆固醇≥5.20 mmol/l 和血清脂质浓度升高的程度与不孕女性第一个完整的 IVF/ICSI 周期的活产率呈负相关。