Neutrophil-to-lymphocyte ratio in females as a predictor of embryo acquisition outcomes after IVF/ICSI treatment: a retrospective study

Objective We aimed to analyze the correlation between the neutrophil-to-lymphocyte ratio (NLR), and the treatment outcomes for infertile women after in vitro fertilization (IVF) using embryo transfer technology. Methods This retrospective study enrolled women with infertility at Huzhou Maternal and Child Health Care Hospital who underwent in vitro IVF procedures. Patient data were collected from a reproductive electronic medical record system. We divided 976 participants into positive and negative groups based on embryo availability after IVF. Age, education level, body mass index, infertility type, etiology, miscarriage history, ovarian stimulation protocols, baseline follicle stimulating hormone levels, anti-Müllerian hormone and NLR were compared in both groups. We investigated the association between NLR and IVF outcomes using logistic regression analysis with multi-model adjustments. The receiver operating characteristic (ROC) curve was used to evaluate the screening efficacy of NLR, The subgroup analysis revealed risk variations among different groups. Finally, we performed sensitivity analysis by modifying control values and conducting logistic regression using NLR quartiles. Results Multimodal adjusted logistic regression analysis revealed a significant association between the second quartile of NLR and negative outcomes of IVF treatment, with an OR value and 95% confidence interval of 0.28 (0.10-0.67). The area under the ROC curve was 0.850