Association between the systemic immune-inflammation index and GnRH antagonist protocol IVF outcomes: a cohort study

Reprod Biomed Online. 2024 May;48(5):103776. doi: 10.1016/j.rbmo.2023.103776. Epub 2023 Dec 19.

Abstract

Research question: What is the relationship between the systemic immune-inflammation index (SII) and IVF outcomes in women undergoing a gonadotrophin-releasing hormone (GnRH) antagonist protocol?

Design: This retrospective cohort study analysed clinical data and blood samples collected before oocyte retrieval from participants undergoing IVF with the GnRH antagonist protocol. Logistic regression and generalized additive models were used to examine the association between SII quartiles and continuous SII values and IVF outcomes.

Results: Higher SII values correlated negatively with biochemical pregnancy, clinical pregnancy, live birth and implantation rates, and positively with early pregnancy loss, independent of age, body mass index, anti-Müllerian hormone and stimulation parameters. The most significant adverse outcomes were observed in the highest SII quartile. A non-linear relationship was identified between log-transformed SII and IVF outcomes, with an inflection point at an SII of approximately 6.72, indicating a threshold effect.

Conclusions: Elevated SII is associated with poorer IVF outcomes in women after the GnRH antagonist protocol, suggesting its potential as a predictive marker in IVF treatments. Further research is needed to confirm these findings and explore the underlying mechanisms.

Keywords: Assisted reproductive technology; Aystemic immune inflammation index; GnRH antagonists; Reproductive outcomes.

MeSH terms

  • Adult
  • Cohort Studies
  • Female
  • Fertilization in Vitro* / methods
  • Gonadotropin-Releasing Hormone* / antagonists & inhibitors
  • Hormone Antagonists / therapeutic use
  • Humans
  • Inflammation
  • Ovulation Induction / methods
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Rate
  • Retrospective Studies

Substances

  • Gonadotropin-Releasing Hormone
  • Hormone Antagonists