Abstract
Background and objectives Uric acid is associated with many systemic diseases. Recent evidence demonstrated that high serum uric acid levels in polycystic ovary syndrome (PCOS) could lead to a poor prognosis of in-vitro fertilisation. The objective of this study was to explore the association between serum uric acid levels and reproductive outcomes in women with PCOS undergoing intrauterine insemination (IUI) treatment. Methods We included 682 patients with PCOS who underwent IUI treatment between 2015 and 2024. They were stratified into three groups according to the level of serum uric acid: normal (251-360 µmol/L), low (≤250 µmol/L), and high (>360 µmol/L). Pregnancy and obstetric outcomes of patients were evaluated and linked to serum uric acid levels. The primary outcome measures of this study were the clinical pregnancy rate and live birth rate. Secondary outcome measures included the rates of biochemical pregnancy, ectopic pregnancy, miscarriage, and low birth weight. Results There was no significant difference between the three groups with respect to clinical pregnancy rate (23.3% vs. 26.2% vs. 30.4%) and live birth rate (86.2% vs. 81.5% vs. 93.6%). Biochemical pregnancy rate (25.1% vs. 28.2% vs. 35.3%), ectopic pregnancy rate (3.5% vs. 1.9% vs. 3.2%), miscarriage rate (10.4% vs. 16.7% vs. 3.2%), and low-birth-weight rate (14.6% vs. 12.5% vs. 19.4%) were comparable among the three groups.In terms of birth weight, the three study groups showed comparable values (3122.8±81.10 vs. 3095.6±68.96 vs. 3099.5±162.09 g), and no significant difference was observed. These results remained the same after adjusting for baseline clinical characteristics and in-hospital treatment. Interpretation and conclusions Our findings demonstrated that maternal pre-pregnancy serum uric acid level was not significantly related to pregnancy and obstetric outcomes following IUI treatment in women with PCOS.