Serum Uric Acid and Intrauterine Insemination Outcomes in Non-Polycystic Ovary Syndrome Women: A Retrospective Study

To investigate the association between serum uric acid (SUA) levels and reproductive outcomes in non-polycystic ovary syndrome (PCOS) women undergoing intrauterine insemination (IUI) treatment.

This retrospective study examined 2448 IUI cycles at a large reproductive health center from 2015 to 2024. They were categorized into four groups according to SUA quartiles. Differences in pregnancy and obstetric outcomes of women without PCOS were compared among these groups. Logistic regression analysis was applied to obtain the odds ratio (OR) and 95% confidence interval (CI) for outcomes with or without adjusting for confounding variables.

There was no significant difference in the biochemical pregnancy rate from the lowest SUA quartile (Q1: 18.81%) to the highest (Q4: 17.81%) (adjusted OR 0.80, 95% CI: 0.58-1.09, P=0.455). Similarly, both the unadjusted and adjusted models indicated that SUA level had no significant effect on most reproductive outcomes including clinical pregnancy rate, miscarriage rate, and live birth rate (P>0.05). Notably, mean birth weight in Q3 (3376.93 ± 64.63 g) was the highest among the four groups (P=0.021). Consistent with this result, the low birth weight rate in Q3 was significantly lower than in Q1 in Model 3 (adjusted OR 0.21, 95% CI: 0.05-0.94, P=0.041) after adjusting for factors such as age, body mass index, menstrual cycle, and systolic blood pressure.

We conclude that pre-pregnancy SUA does not impair reproductive outcomes in women without PCOS undergoing IUI treatment. Fetal growth and subsequent birth weight would appear to benefit from an appropriate maternal SUA level. However, the precise efficacy and mechanism of action need to be further investigated.