Association between estimated glucose disposal rate and female infertility based on NHANES 2013 to 2020

Insulin resistance and impaired glucose metabolism are critical factors influencing female reproductive health. This study aimed to evaluate the association between estimated glucose disposal rate (eGDR), a surrogate marker of insulin resistance, and female infertility in the general population. We conducted a cross-sectional analysis of women aged 20 to 45 years from the National Health and Nutrition Examination Survey 2013 to 2020. Multivariable logistic regression, restricted cubic spline analysis, threshold analysis, and subgroup analyses were used to assess the association between eGDR and infertility. A total of 2430 women were included, and the prevalence of infertility was 14.9%. After adjustment for potential confounders, eGDR was negatively associated with the risk of female infertility (odds ratio [OR] = 0.80, 95% confidence interval [CI]: 0.70-0.92; P = .001). In tertile analyses, women in the highest eGDR tertile had a lower risk of infertility than those in the lowest tertile (OR = 0.51, 95% CI: 0.31-0.84; P = .009), with a significant trend across tertiles. Threshold analysis identified an inflection point at an eGDR value of 4.96. Subgroup analyses showed a significant interaction between eGDR and age. Higher eGDR was significantly associated with a lower risk of female infertility among U.S. women. These findings suggest that eGDR may be a useful marker for evaluating infertility risk related to insulin resistance.