Association of hyperhomocysteinemia with IVF live birth rate: A retrospective cohort study

Homocysteine (Hcy) has been reported to be associated with female reproduction. However, the correlation between hyperhomocysteinemia (HHcy) and pregnancy outcomes among infertile women remains unclear. This observational study aims to evaluate the effect of HHcy on pregnancy outcomes in infertile patients undergoing ART treatment.

Data were collected from 385 patients (50 in the HHcy group and 335 in the non-HHcy group) who underwent In Vitro Fertilization/Intracytoplasmic Sperm Injection (IVF/ICSI) at the First Affiliated Hospital of University of Science and Technology of China. Clinical outcomes between the two groups were analyzed.

The number of oocytes retrieved, MII oocytes, oocyte maturation rate and normal fertilization rate did not differ significantly between the two groups. However, the HHcy group exhibited significantly lower rates of biochemical pregnancy (48 % vs. 74.9 %), clinical pregnancy (38 % vs. 63.9 %) and live births (34 % vs. 52.8 %) in the HHcy group compared to non-HHcy group. Logistic regression analyses indicated that HHcy was negatively associated with biochemical pregnancy rate (OR= 0.28, 95 % CI: 0.14-0.54, P < 0.001), clinical pregnancy rate (OR = 0.32, 95 % CI: 0.16-0.61, P < 0.001) and live birth rate (OR = 0.45, 95 % CI: 0.23-0.86, P = 0.02).

HHcy exhibited a negative correlation with live birth among patients underwent IVF/ICSI. Clinicians should consider focusing more attention on patients with HHcy to enhance ART outcomes.