Low-grade inflammation is negatively associated with live birth in women undergoing IVF
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Low-grade inflammation is negatively associated with live birth in women undergoing IVF. / Vexø, Laura Emilie; Stormlund, Sacha; Kloeve Landersoe, Selma; Løvendahl Jørgensen, Henrik; Humaidan, Peter; Bergh, Christina; Englund, Anne Lis Mikkelsen; Klajnbard, Anna; Bogstad, Jeanette Wulff; Freiesleben, Nina la Cour; Zedeler, Anne; Prætorius, Lisbeth; Nyboe Andersen, Anders; Løssl, Kristine; Pinborg, Anja; Svarre Nielsen, Henriette.
In: Reproductive BioMedicine Online, Vol. 46, No. 2, 2023, p. 302-311.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Low-grade inflammation is negatively associated with live birth in women undergoing IVF
AU - Vexø, Laura Emilie
AU - Stormlund, Sacha
AU - Kloeve Landersoe, Selma
AU - Løvendahl Jørgensen, Henrik
AU - Humaidan, Peter
AU - Bergh, Christina
AU - Englund, Anne Lis Mikkelsen
AU - Klajnbard, Anna
AU - Bogstad, Jeanette Wulff
AU - Freiesleben, Nina la Cour
AU - Zedeler, Anne
AU - Prætorius, Lisbeth
AU - Nyboe Andersen, Anders
AU - Løssl, Kristine
AU - Pinborg, Anja
AU - Svarre Nielsen, Henriette
N1 - Publisher Copyright: © 2023 The Authors
PY - 2023
Y1 - 2023
N2 - Research question: Is low-grade inflammation, detected by C-reactive protein (CRP), a marker of IVF outcome addressing both blastocyst quality and pregnancy outcome? Design: This sub-study of a multicentre randomized controlled trial included 440 women undergoing IVF treatment with a gonadotrophin-releasing hormone (GnRH) antagonist protocol. Serum CRP was measured on cycle day 2–3 (baseline) and on the day of ovulation triggering. The association between CRP concentrations and reproductive outcomes (number of retrieved oocytes, number of good-quality blastocysts, pregnancy, pregnancy loss and live birth), were analysed, adjusting for relevant confounders. Results: A negative association was found between higher baseline CRP concentrations and live birth rate (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.62–0.96, P = 0.02) and higher CRP concentrations at baseline were associated with pregnancy loss among women who conceived (OR 1.37, 95% CI 1.07–1.76, P = 0.01). When testing for a specific cut-off, CRP concentrations above 2.34 (the highest quartile) were more likely to be associated with pregnancy loss (P = 0.02) and a lower chance of live birth (P = 0.04) compared with the lowest quartile. No associations were found between CRP concentrations and pregnancy outcomes on the day of ovulation triggering, and there were no associations between CRP concentrations and the number of good-quality blastocysts. Conclusions: Higher CRP concentrations at cycle day 2–3, before starting ovarian stimulation, are negatively associated with chance of live birth, possibly because of an increased risk of pregnancy loss. No association was found between the number of good-quality blastocysts and CRP concentration. More studies are needed to investigate the impact of low-grade inflammation.
AB - Research question: Is low-grade inflammation, detected by C-reactive protein (CRP), a marker of IVF outcome addressing both blastocyst quality and pregnancy outcome? Design: This sub-study of a multicentre randomized controlled trial included 440 women undergoing IVF treatment with a gonadotrophin-releasing hormone (GnRH) antagonist protocol. Serum CRP was measured on cycle day 2–3 (baseline) and on the day of ovulation triggering. The association between CRP concentrations and reproductive outcomes (number of retrieved oocytes, number of good-quality blastocysts, pregnancy, pregnancy loss and live birth), were analysed, adjusting for relevant confounders. Results: A negative association was found between higher baseline CRP concentrations and live birth rate (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.62–0.96, P = 0.02) and higher CRP concentrations at baseline were associated with pregnancy loss among women who conceived (OR 1.37, 95% CI 1.07–1.76, P = 0.01). When testing for a specific cut-off, CRP concentrations above 2.34 (the highest quartile) were more likely to be associated with pregnancy loss (P = 0.02) and a lower chance of live birth (P = 0.04) compared with the lowest quartile. No associations were found between CRP concentrations and pregnancy outcomes on the day of ovulation triggering, and there were no associations between CRP concentrations and the number of good-quality blastocysts. Conclusions: Higher CRP concentrations at cycle day 2–3, before starting ovarian stimulation, are negatively associated with chance of live birth, possibly because of an increased risk of pregnancy loss. No association was found between the number of good-quality blastocysts and CRP concentration. More studies are needed to investigate the impact of low-grade inflammation.
KW - Blastocyst quality
KW - C-reactive protein
KW - Live birth
KW - Low-grade inflammation
KW - Pregnancy
KW - Pregnancy loss
U2 - 10.1016/j.rbmo.2022.10.004
DO - 10.1016/j.rbmo.2022.10.004
M3 - Journal article
C2 - 36446681
AN - SCOPUS:85142778731
VL - 46
SP - 302
EP - 311
JO - Reproductive BioMedicine Online
JF - Reproductive BioMedicine Online
SN - 1472-6483
IS - 2
ER -
ID: 341062858