Reproductive biomedicine online · 2026
Dyslipidaemia is negatively associated with fertility, pregnancy and neonatal outcomes in women undergoing IVF treatment.
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Wang Zheng, Song Ying, Song Yan, Wang Yuanyuan, Yang Rui, Huang Shuo, Li Rong, Mol Ben W, Qiao Jie
Аннотация
RESEARCH QUESTION: Is maternal dyslipidaemia associated with fertility, pregnancy and neonatal outcomes in women undergoing IVF treatment, and if so, are there potential linear or non-linear associations between specific lipid types and clinical outcomes?
DESIGN: This retrospective cohort study was conducted at a single centre, including women undergoing their first IVF cycle between January 2018 and December 2021. Participants were classified as dyslipidaemic or not dyslipidaemic. The primary outcome was cumulative live births after the first complete IVF cycle. Both linear and non-linear associations between lipid [total cholesterol, triglyceride, low-density-lipoprotein cholesterol (LDL-C) and high-density-lipoprotein cholesterol (HDL-C)] concentrations and outcomes were examined using multivariable logistic regression and restricted cubic splines. Subgroup analyses were performed by maternal age and body mass index (BMI).
RESULTS: In total, 25,413 women were included in this study, of whom 8495 (33.4%) had hyperlipidaemia. Age and BMI were higher in the hyperlipidaemia group. The live birth rate was 41.5% (3526/8495) in the hyperlipidaemia group and 48.0% (8116/16,918) in the control group (adjusted OR 0.86, 95% CI 0.81-0.91). Total cholesterol, triglyceride and LDL-C concentrations showed negative linear associations with live birth rate, whereas HDL-C concentration did not. A steep decline in live birth rate was observed when total cholesterol concentration exceeded the cut-off of 4 mmol/l (154.7 mg/dl). In normal-weight women aged <38 years, the live birth rate was lower in the hyperlipidaemia group compared with the control group (adjusted OR 0.84, 95% CI 0.77-0.91). There were no significant differences in pregnancy outcomes in overweight and obese women or in women aged >38 years between the hyperlipidaemia group and the control group.
CONCLUSION: In normal-weight women aged <38 years, hyperlipidaemia was associated with a higher pregnancy loss rate and a lower cumulative live birth rate. Total cholesterol, triglyceride and LDL-C concentrations were negatively associated with live birth rate, while HDL-C concentration was not.
DESIGN: This retrospective cohort study was conducted at a single centre, including women undergoing their first IVF cycle between January 2018 and December 2021. Participants were classified as dyslipidaemic or not dyslipidaemic. The primary outcome was cumulative live births after the first complete IVF cycle. Both linear and non-linear associations between lipid [total cholesterol, triglyceride, low-density-lipoprotein cholesterol (LDL-C) and high-density-lipoprotein cholesterol (HDL-C)] concentrations and outcomes were examined using multivariable logistic regression and restricted cubic splines. Subgroup analyses were performed by maternal age and body mass index (BMI).
RESULTS: In total, 25,413 women were included in this study, of whom 8495 (33.4%) had hyperlipidaemia. Age and BMI were higher in the hyperlipidaemia group. The live birth rate was 41.5% (3526/8495) in the hyperlipidaemia group and 48.0% (8116/16,918) in the control group (adjusted OR 0.86, 95% CI 0.81-0.91). Total cholesterol, triglyceride and LDL-C concentrations showed negative linear associations with live birth rate, whereas HDL-C concentration did not. A steep decline in live birth rate was observed when total cholesterol concentration exceeded the cut-off of 4 mmol/l (154.7 mg/dl). In normal-weight women aged <38 years, the live birth rate was lower in the hyperlipidaemia group compared with the control group (adjusted OR 0.84, 95% CI 0.77-0.91). There were no significant differences in pregnancy outcomes in overweight and obese women or in women aged >38 years between the hyperlipidaemia group and the control group.
CONCLUSION: In normal-weight women aged <38 years, hyperlipidaemia was associated with a higher pregnancy loss rate and a lower cumulative live birth rate. Total cholesterol, triglyceride and LDL-C concentrations were negatively associated with live birth rate, while HDL-C concentration was not.