Adverse effects of dyslipidemia on embryo quality and reproductive outcomes in specific subgroups undergoing first IVF/ICSI cycles: A case-control study.

This study aims to assess associations of dyslipidemia with in vitro fertilization/intracytoplasmic sperm injection outcomes in women undergoing their first ovarian stimulation and whether age, body mass index, or lipid levels modify these effects. This retrospective cohort study analyzed data from 327 dyslipidemic and 756 normal lipid women undergoing first in vitro fertilization/intracytoplasmic sperm injection cycle between April 2016 and March 2023. Primary outcomes included high-quality cleavage embryo rate, cumulative clinical pregnancy rate (CCPR), and cumulative live birth rate (CLBR). Generalized linear model and subgroup analysis adjusted for confounders. Overall, dyslipidemia showed no significant association with high-quality cleavage embryo rate, CCPR, or CLBR (all P > .05) but was associated with a lower oocyte retrieval rate (P = .025). Subgroup analysis showed that dyslipidemia was negatively associated with oocyte retrieval rate (adjusted odds ratio [aOR] [95% confidence interval [CI]]: 0.954 [0.911-0.999], P = .043) in women aged ≥35 years, with CCPR (aOR [95% CI]: 0.661 [0.459-0.953], P = .027) and CLBR (aOR [95% CI]: 0.667 [0.473-0.940], P = .021) in women aged <35 years, and cleavage rate (aOR [95% CI]: 0.901 [0.817-0.993], P = .036) in women with body mass index ≥28 kg/m2. Furthermore, marginally elevated triglyceride (TG) levels significantly reduced oocyte retrieval rate versus normal TG (aOR [95% CI]: 0.950 [0.912-0.988], P = .012). Dyslipidemia is associated with decreased CCPR and CLBR in young women, oocyte retrieval rate in elderly women, and cleavage rate in women with obesity. Marginally elevated TG levels associated with lower oocyte retrieval. Further large-scale prospective studies are warranted to validate these findings.