AJOG global reports · 2026
A retrospective study of the relationship between low-density lipoprotein cholesterol and pregnancy outcomes after assisted reproductive technology treatments in women with diabetes mellitus and infertility.
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Yuan Chun, Guo Yuan, Wang Jing, Guo Jinghui, Liu Jinyong
Аннотация
BACKGROUND: This study aimed to investigate the role of low-density lipoprotein cholesterol as a key parameter in improving pregnancy outcomes after assisted reproductive technology treatments in women with diabetes mellitus.
OBJECTIVE: To investigate the relationship between low-density lipoprotein cholesterol and pregnancy outcomes after assisted reproductive technology treatments in women with diabetes and infertility.
STUDY DESIGN: 474 female patients diagnosed with diabetes were included in this study. The patients were divided into the high LDL-C group (≥3 mmol/L) and the low LDL-C group (<3 mmol/L). According to the protocol of ovarian stimulation, the clinical characteristics in ART cycles and pregnancy outcomes were compared separately. The data were analyzed after propensity score matching.
RESULTS: In the GnRH antagonist protocol group, there were no significant differences in baseline characteristics between the high- and low-LDL-C groups. Nevertheless, ART treatment characteristics and pregnancy outcomes did not differ significantly between the 2 groups (P>.05). However, the rate of early miscarriage in GnRH antagonist protocol-FET cycles had a significantly positive association with LDL-C level (P=.0004).In the long-acting GnRH agonist protocol group, there were no significant differences in baseline characteristics between the high- and low-LDL-C groups; however, total cholesterol, triglycerides, and AST/ALT levels were significantly higher in the high-LDL-C group (P<.05). Although the clinical pregnancy rate of fresh embryo cycles in the high-LDL-C group was considerably higher than that of the low-LDL-C group (P=.001), there was a statistical difference in the early miscarriage rate between the 2 groups. (P<.05).
CONCLUSION: This study demonstrates that in infertile women with diabetes mellitus undergoing ART, elevated pretreatment LDL-C is a significant and modifiable marker associated with an increased risk of early miscarriage and a reduced live birth rate. The impact of LDL-C varies by ovarian stimulation protocol. These findings underscore the importance of integrating preconception lipid management into the clinical pathway and adopting a protocol-specific risk assessment to optimize pregnancy outcomes.
OBJECTIVE: To investigate the relationship between low-density lipoprotein cholesterol and pregnancy outcomes after assisted reproductive technology treatments in women with diabetes and infertility.
STUDY DESIGN: 474 female patients diagnosed with diabetes were included in this study. The patients were divided into the high LDL-C group (≥3 mmol/L) and the low LDL-C group (<3 mmol/L). According to the protocol of ovarian stimulation, the clinical characteristics in ART cycles and pregnancy outcomes were compared separately. The data were analyzed after propensity score matching.
RESULTS: In the GnRH antagonist protocol group, there were no significant differences in baseline characteristics between the high- and low-LDL-C groups. Nevertheless, ART treatment characteristics and pregnancy outcomes did not differ significantly between the 2 groups (P>.05). However, the rate of early miscarriage in GnRH antagonist protocol-FET cycles had a significantly positive association with LDL-C level (P=.0004).In the long-acting GnRH agonist protocol group, there were no significant differences in baseline characteristics between the high- and low-LDL-C groups; however, total cholesterol, triglycerides, and AST/ALT levels were significantly higher in the high-LDL-C group (P<.05). Although the clinical pregnancy rate of fresh embryo cycles in the high-LDL-C group was considerably higher than that of the low-LDL-C group (P=.001), there was a statistical difference in the early miscarriage rate between the 2 groups. (P<.05).
CONCLUSION: This study demonstrates that in infertile women with diabetes mellitus undergoing ART, elevated pretreatment LDL-C is a significant and modifiable marker associated with an increased risk of early miscarriage and a reduced live birth rate. The impact of LDL-C varies by ovarian stimulation protocol. These findings underscore the importance of integrating preconception lipid management into the clinical pathway and adopting a protocol-specific risk assessment to optimize pregnancy outcomes.