Baseline Cardiometabolic, Hepatic and Renal Profile of Infertile Women and Pregnancy Status Following Assisted Reproduction Technology Procedure

Abstract

BACKGROUND: Routinely, the focus of pre-assisted reproduction technology (ART) assessments is ovarian reserve hormones and semen parameters. However, a growing body of research suggests that systemic metabolic health is a critical determinant of reproductive outcomes. The study therefore sought to evaluate disparities in baseline cardiometabolic, hepatic, renal and haematologic factors in infertile women and their pregnancy status following the ART procedure. METHODS: This cross-sectional baseline assessment with prospective follow-up study was conducted at The Chosen Hospital and Fertility Centre in Accra, Ghana, from January 2024 to March 2025. The study involved 206 infertile women aged from 28 to 60 years. Venous blood samples were collected and analysed for fasting lipids, complete blood count and renal and liver function, before any ART procedure. The pregnancy status of women was determined after the ART procedure as either positive or negative, and whether their infertility type was primary, secondary or subfertility. RESULTS: In the multivariable analysis, the chloride level was 0.164 mmol/L higher in women who achieved post-ART pregnancy with an adjusted odds ratio (95% CI) of 1.179 (1.017-1.366). The proportion of eosinophils was higher in subfertility than in primary infertility (3.7 ± 1.8 vs. 2.3 ± 1.5, p < 0.050). In addition, the mean platelet volume (10.4 ± 1.8 vs. 9.8 ± 1.5 vs. 8.3 ± 1.1, p < 0.050) and the platelet distribution width (13.3 ± 3.0 vs. 12.4 ± 2.7 vs. 9.9 ± 1.8, p < 0.050) were higher in secondary infertility than primary and subfertility. CONCLUSION: As a routinely available and inexpensive biomarker, serum chloride could enhance pre-ART assessment if confirmed in larger prospective studies. The MPV, PDW and eosinophil proportion across infertility types may be indicators of distinct underlying pathophysiological pathways in different infertility diagnoses.