The reproductive health and quality of life of women are profoundly affected by uterine fibroids, which are benign tumors of the myometrium. By reviewing the existing literature, speculating on possible causes, and drawing attention to gaps in our understanding, this review seeks to delve into the complex system of links between uterine fibroids and cancer susceptibility. Future research on women’s health could benefit from considering the findings of this review, alongside emerging evidence, to inform clinical decision-making.

This review examines the epidemiology and clinical relevance of uterine fibroids, which are widespread and significantly affect women’s health. This review explores the molecular causes and pathophysiology of uterine fibroids with a focus on genetic, epigenetic, and hormonal factors. It also evaluates the correlation between fibroids and various cancers, such as endometrial cancer and leiomyosarcoma, while addressing the challenges of distinguishing benign from malignant tumors and the potential causes of malignant transformation.

Uterine fibroids are typically benign, but they have the potential to become malignant in certain cases. Therefore, early diagnosis and effective treatment methods, including histopathology, cancer biomarkers, and advanced imaging techniques, are crucial for identifying and managing malignant transformation. Patient education is vital for empowering individuals to recognize the early signs and symptoms of uterine fibroids, leading to timely medical consultation and better management outcomes.

This review emphasizes the need for continued research to refine our understanding of the relationship between uterine fibroids and cancer risk with the aim of enhancing diagnostic and therapeutic strategies to improve patient outcomes.

This study aimed to investigate serum levels of calcitonin gene-related peptide (CGRP) and explore potential associations between serum CGRP, adiponectin, and ghrelin concentrations in patients with preeclampsia.

This study evaluated 43 normotensive healthy pregnant women and 36 pregnant women diagnosed with preeclampsia. Serum concentrations of CGRP, adiponectin, and ghrelin were measured in both groups during the third trimester of pregnancy.

Serum concentrations of CGRP were significantly elevated in the preeclampsia group compared to the control group. Conversely, the preeclampsia group exhibited significantly decreased serum levels of adiponectin and ghrelin relative to the controls. No significant correlation was observed between serum CGRP levels and adiponectin or ghrelin levels in either the preeclampsia or control groups.

Our study demonstrates a considerable increase in serum CGRP concentrations in patients with preeclampsia compared to the control group. These outcomes strongly indicate that CGRP may play a pivotal role in the pathogenesis of preeclampsia.

Metabolic processes involving homocysteine and associated micronutrients (e.g., vitamin B12 and folic acid) are critical for cellular function, vascular development, and hormonal regulation during pregnancy, and they play a crucial role in both maternal and fetal health. However, evidence on the effects of micronutrient supplementation in preventing pregnancy-related complications remains limited. This prospective cohort study aims to investigate the effects of maternal micronutrient status and homocysteine levels in early pregnancy, with a focus on their potential impact on maternal and fetal health outcomes in a Turkish population.

First-trimester blood parameters and sociodemographic data were recorded from 79 pregnant women, who were then followed until delivery. Serum levels of ferritin, vitamin D, folic acid, vitamin B12, and homocysteine were measured. Maternal and fetal complications were monitored throughout pregnancy, and any pregnancy-related adverse outcomes were documented. Participants with low micronutrient levels received supplementation.

Pregnancy-related maternal and fetal complications were as follows: gestational diabetes mellitus (21%), gestational hypertension (13%), hypothyroidism during pregnancy (17%), and preterm birth (25%). There were no significant differences in maternal blood parameters, including vitamin B12, vitamin D, folic acid, ferritin, international normalized ratio (INR), homocysteine, or hemogram levels between pregnant women with complications and those without (p > 0.05).

Our findings suggest that neither micronutrient levels nor homocysteine alone account for pregnancy complications. However, this study underscores the potential combined impact of these factors on maternal and fetal outcomes.

Endometriosis, a common cause of infertility, adversely impacts both the quality and quantity of oocytes and embryos, with increasing severity negatively influencing assisted reproductive technology (ART) outcomes. This study aims to elucidate and compare the efficacy of two fertilization methods: conventional in vitro fertilization (IVF) following short in vitro maturation (IVM) versus intracytoplasmic sperm injection (ICSI) in patients with varying stages of endometriosis.

In this retrospective study, a total of 134 infertile patients with endometriosis undergoing IVF-ICSI treatment were included. The patients were classified into two groups based on the stage of endometriosis: Stage I–II (n = 79, Group 1) and stage III–IV (n = 55, Group 2). Within each group, participants underwent ART treatments in which sibling oocytes were randomly assigned to either conventional IVF following a short IVM period or the ICSI group. The primary outcomes—fertilization rate, embryo formation rate, and the proportion of high-quality embryos—were assessed and compared between subgroups using the Mann-Whitney U test.

Among patients with stage I–II endometriosis, no significant differences were observed between the IVF following short IVM and ICSI subgroups regarding fertilization rate (70 vs. 73, p = 0.543), embryo formation rate (86 vs. 90, p = 0.444), or high-quality embryo rate (67 vs. 71, p = 0.570). Similarly, in the stage III–IV endometriosis group, fertilization rate, embryo formation rate, and the proportion of top-quality embryos on day 3 did not differ significantly between the two subgroups (p > 0.05).

Our findings indicated that conventional IVF following a short IVM period yielded comparable outcomes to ICSI in patients with varying stages of endometriosis. Therefore, conventional IVF following a short IVM period may be considered an effective and less invasive fertilization approach for the management of endometriosis-associated infertility.

Surgical site infection (SSI) following breast surgery remain a significant clinical challenge, with reported incidence rates ranging from 1% to 35%. Despite advancements in surgical techniques, SSIs contribute to prolonged hospitalization, increased mortality, and substantial healthcare costs. This research applied a quantitative systematic review and meta-analysis to identify and summarize risk factors for SSIs following breast surgery.

Relevant literature from PubMed, Medline, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials published between January 1, 2004, and December 25, 2023, was searched and screened using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) procedure. The effect sizes for each identified risk factor were calculated using STATA v18 and RevMan 5.3. Heterogeneity was tested using the Q-test, and sensitivity analysis was performed using the leave-one-out method, in which one dataset was removed at a time to evaluate changes in the pooled effect sizes. A funnel plot was employed to evaluate potential publication bias.

12 studies were identified, including 2412 SSI-positive and 166,794 SSI-negative cases undergoing breast surgery. 22 potential risk factors were identified, and those reported in ≥3 studies were analyzed. Mastectomy emerged as the strongest risk factor (odds ratio [OR] = 2.61, p < 0.001), followed by diabetes (OR = 2.49, p < 0.001), body mass index (BMI) ≥25 kg/m² (OR = 2.08, p < 0.001), American Society of Anesthesiologists (ASA) score ≥3 (OR = 1.99, p < 0.001), and smoking (OR = 1.38, p < 0.001).

Patients who underwent mastectomy demonstrated 2.61 times higher odds of developing SSI post-breast surgery (OR = 2.61). Similarly, diabetes was associated with more than twice the odds of developing SSIs (OR = 2.49), BMI ≥25 kg/m² with twofold increase in odds (OR = 2.08), ASA score ≥3 with 99% higher odds (OR = 1.99), and smoking with a 38% increased odds (OR = 1.38). This study highlights the importance of closely monitoring surgical incisions in patients with a history of smoking, high ASA scores, or those who have undergone mastectomy. BMI and diabetes may affect each other; therefore, future studies should provide detailed reporting on the number of patients with these correlated factors.

The study has been registered on https://www.crd.york.ac.uk/prospero/ (registration number: CRD42023492359).

Uterine rupture (UR) is a rare but severe obstetric complication that significantly affects maternal and neonatal health. Despite extensive ongoing research on UR risk factors, controlling for confounding variables remains crucial to ensure accurate risk assessment and the development of effective preventive measures. Therefore, this study aimed to explore the potential risk factors for UR during pregnancy to improve preventive measures and therapeutic strategies.

A retrospective analysis was conducted on medical records of pregnant women with UR from January 2019 to December 2023 across 11 hospitals in Jiangsu province, China. For comparison, a control group without UR (non-UR group) comprising twice the number of UR cases, was randomly selected from the pool of women with uncomplicated pregnancies during the same period. Subsequently, patients diagnosed with UR (UR group) were matched 1:1 with those without UR (non-UR group) based on age, body mass index, blood pressure, and adequacy of prenatal care. The association between group status and risk factors was examined using multivariable analysis.

Among 306,336 singleton pregnancies across 11 hospitals, 72 UR cases were identified, leading to a rupture rate of 2.4 per 10,000 deliveries. Following propensity score matching (PSM), 62 patients in the UR group were compared with 62 patients in the non-UR group. Univariate analyses revealed a significantly higher incidence of cesarean section and a history of uterine surgery history among UR patients compared to non-UR patients. Multivariable analysis identified multiple uterine surgeries as an independent risk factor for UR (odds ratio [OR]: 3.141; 95% confidence interval [CI]: 1.903–5.183; p < 0.001).

This study emphasizes the significance of multiple uterine surgeries as a potential independent risk factor for UR. Recognizing such risk factors is pivotal for refining perinatal management strategies aimed at reducing the incidence of UR. Ultimately, this reduction can significantly enhance maternal and neonatal health outcomes.

This study aimed to determine the findings of histological chorioamnionitis (HCA) that may lead to preterm labor.

A total of 126 women who underwent cesarean delivery at our hospital’s obstetrics clinic between May 1 and December 31, 2022, were prospectively included in the study (Group 1, Term labor, n = 63, Group 2, Preterm labor, n = 63). Participants’ sociodemographic characteristics, laboratory results, and histopathological findings were documented and compared between the groups. Placentas were examined for the diagnosis of HCA by a senior pathologist.

Significant differences were observed between Group 1 and Group 2 in gestational age at delivery (38.6 ± 1.3 vs 33.6 ± 1.6 weeks, respectively; p < 0.001), Apgar scores at the first minute (8.8 ± 0.6 vs 8.1 ± 1.8; p < 0.001), and neonatal intensive care unit (NICU) admission (9.5% vs 42.9%; p < 0.001). Although hemoglobin (Hb) levels, mean platelet volume (MPV), mean corpuscular volume (MCV), and lymphocyte, neutrophil, monocyte, platelet counts, as well as the pan-inflammatory value at admission, were comparable between groups (p > 0.05), leukocyte counts (10,382.54 ± 2020.58 vs 12,133.33 ± 4936.01, respectively; p = 0.011), neutrophil-lymphocyte ratio (4.21 ± 1.60 vs 5.46 ± 1.48; p = 0.040), and C-reactive protein (CRP) values (6.46 ± 5.56 vs 15.90 ± 9.27 g/dL; p = 0.027) differed significantly between the two groups. The incidence of acute (7.9% vs 49.2%), mild (33.3% vs 49.2%), and moderate (3.2% vs 14.3%) chorioamnionitis was statistically significantly higher in the preterm labor group (p < 0.05).

The study findings show that the prevalence of HCA is notably higher in pregnant women with preterm deliveries, and that both the neutrophil-to-lymphocyte ratio and CRP levels are higher in preterm compared to term deliveries. Further studies with larger cohorts are warranted to elucidate these associations.

This study employed a meta-analysis approach to investigate the incidence of intrahepatic cholestasis of pregnancy (ICP) and its impact on adverse outcomes in both pregnant and postpartum women, as well as neonates.

We obtained studies published from the inception of the PubMed, Cochrane Library, and Web of Science databases through January 2024. A total of 21 original articles were included, reporting on ICP and its associated adverse outcomes in maternal and neonatal populations. The included studies involved 1,497,951 controls non-intrahepatic cholestasis of pregnancy (non-ICP) and 12,262 ICP patients. Sensitivity analyses and evaluations for publication bias were also conducted.

The pooled analysis estimated an ICP incidence of 3% (95% confidence interval [CI], 1%–7%), while the meta-analysis demonstrated the following risk ratios: postpartum hemorrhage showed a relative risk (RR, 0.82; 95% CI, 0.69–0.99), whereas significant increases were observed for preeclampsia (RR, 2.39; 95% CI, 2.21–2.59), Cesarean section (RR, 1.28; 95% CI, 1.15–1.42), preterm birth (RR, 2.71; 95% CI, 1.77–4.15), and maternal infection (RR, 3.22; 95% CI, 2.48–4.19). Other outcomes included labor induction (RR, 1.60; 95% CI, 0.51–4.99), gestational diabetes mellitus (GDM; RR, 1.29; 95% CI, 0.83–2.01), stillbirth (RR, 1.25; 95% CI, 0.64–2.42), and small for gestational age (SGA; RR, 1.06; 95% CI, 0.71–1.57), which were not statistically significant. Neonatal intensive care unit (NICU) admission (RR, 1.79; 95% CI, 1.35–2.37), with a significant increase in risk.

This meta-analysis demonstrates a global incidence of ICP at 3% and identifies significant associations with adverse maternal and neonatal outcomes. ICP is associated with increased risks of preeclampsia, Cesarean section, preterm birth, maternal infection, and neonatal intensive care needs. Interestingly, a relative risk of postpartum hemorrhage was observed, suggesting the need for further investigation into the underlying mechanisms. Although labor induction, GDM, and stillbirth showed non-significant trends toward increased risk, their clinical relevance persists. These findings underscore the necessity for risk-stratified surveillance in ICP management, emphasizing infection control and preterm prevention, alongside regionally tailored clinical protocols.

The study has been registered on https://inplasy.com/inplasy-2025-3-0132/ (registration number: INPLASY202530132).

Tubal pregnancy, the most common ectopic type, requires urgent intervention. While medical therapy preserves fertility, diagnostic curettage (D&C) is often used if imaging is inconclusive. While medical therapy preserves fertility, D&C is often used if imaging is inconclusive.

A retrospective cohort study was conducted to analyze the clinical data of patients with tubal pregnancies who were hospitalized at the First Affiliated Hospital of Guangzhou University of Chinese Medicine, from 2017 to 2021. Univariate analysis and multivariate logistic regression were used to adjust for confounding factors. A subgroup analysis stratified by human chorionic gonadotropin (hCG) level was also performed to investigate the impact of D&C on treatment outcomes.

The overall failure rate of medical treatment was 24.39% (90/369), with 40.00% (36/90) in the curettage group and 19.35% (54/279) in the control group, showing a significant difference (p < 0.001). After adjusting for confounding factors, logistic regression indicated that the curettage group had a significantly higher failure rate of medical treatment compared to the control group (p = 0.012), with an adjusted odds ratio (OR) of 2.261 (95% confidence interval [CI]: 1.193–4.283). In other words, patients with tubal pregnancy who underwent curettage had a 2.261-fold higher risk of treatment failure compared to those who did not. In subgroup analysis, among patients with serum hCG ≤2000 IU/L, the curettage group had a significantly higher treatment failure rate than the control group (adjusted OR [95% CI] = 2.856 [1.388–5.875], p = 0.004). However, no significant difference was observed among patients with serum hCG >2000 IU/L (p > 0.05).

D&C may increase the risk of medical treatment failure in patients with tubal pregnancy and serum hCG levels ≤2000 IU/L.

This study aimed to explore the factors influencing the development of intrauterine adhesions (IUA) in patients with endometrial polyps (EP) following hysteroscopic resection. We also aimed to construct a nomogram model to predict the risk of postoperative IUA and validate its predictive accuracy.

We conducted a retrospective analysis of data from 322 EP patients treated at our hospital between July 2022 and June 2024. The patients were randomly divided into a modeling group (n = 248) and a verification group (n = 74). Based on whether IUA occurred after hysteroscopic resection, the modeling group was further categorized into an IUA group and a non-IUA group. Data from the modeling group were collected and compared between the two subgroups. We used logistic regression to identify the factors contributing to postoperative IUA. The nomogram model was built using R software, and internal validation was conducted using receiver operating characteristic (ROC) curves, calibration curves, and decision curves. Additionally, we performed external validation using the verification group.

The incidence of postoperative IUA in the modeling group was 20.56% (51/248). Logistic regression analysis revealed that the use of intrauterine devices, history of pelvic inflammatory disease, previous curettage, history of pregnancy termination, and surgical duration were significant risk factors for the development of postoperative IUA (p < 0.050). The area under the curve (AUC) for both the modeling and verification groups was 0.815 (95% CI: 0.753–0.876) and 0.808 (95% CI: 0.747–0.870), respectively. The calibration curve indicated that the predicted probability of IUA occurrence closely matched the actual observed values. The decision curve analysis demonstrated that the predictive model had strong clinical applicability.

The nomogram model, based on five independent risk factors—use of intrauterine devices, history of pelvic inflammatory disease, previous curettage, history of pregnancy termination, and surgical duration—has shown good predictive performance and significant clinical utility in assessing the risk of postoperative IUA in EP patients.

The association between uterine fibroids and mortality remains inconclusive. This study evaluated the relationship between uterine fibroids and all-cause, cancer-specific, and cardiovascular disease (CVD)-specific mortality using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2006.

A cohort analysis was conducted using NHANES data from 1999 to 2006. Weighted Cox proportional hazards regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) to assess associations between uterine fibroids, age at diagnosis, and mortality outcomes. Subgroup analyses and interaction tests were performed to evaluate potential effect modification.

The study cohort comprised 5547 women aged 20–54 years across four survey cycles. During a median follow-up of 16.75 years, 290 deaths were recorded. After adjustment for confounders, no statistically significant associations were observed for all-cause mortality (HR: 0.96; 95% CI: 0.65–1.42), cancer-specific mortality (HR: 1.12; 95% CI: 0.64–1.96), or CVD-related mortality (HR: 0.90; 95% CI: 0.38–2.14). Age-stratified analyses similarly revealed no significant associations across diagnostic age groups.

These results indicate no elevated risk of all-cause, cancer-specific, or CVD-specific mortality associated with uterine fibroids.

Male infertility is a critical factor in the success of in vitro fertilization (IVF), yet a comprehensive predictive model for assessing its risk remains lacking. This study aimed to explore the factors affecting the high-quality embryo rate in male infertility patients, as well as to develop targeted intervention measures.

A retrospective analysis was performed using clinical data from 373 infertility couples who underwent IVF treatment, and the couples were grouped based on a high-quality embryo rate of ≥45% and <45% for statistical analysis. We developed an outcome prediction model and a causal effect estimation model to evaluate the impact of different intervention measures, based on the results of univariate logistic regression analysis.

The results demonstrated significant differences in Antral Follicle Count (AFC), sperm DNA fragmentation index (DFI), male height, male weight, and mycoplasma infection. Further univariate logistic regression analysis identified that AFC, basal luteinizing hormone (LH), sperm DFI, male height, male weight, and mycoplasma infection significantly affected the high-quality embryo rate, all showing negative correlations. The dataset was divided into a training set (80%) and a test set (20%) for the construction and validation of the outcome prediction model and the causal effect estimation model. The causal effect estimation model for mycoplasma infection demonstrated that treating mycoplasma infection could increase the high-quality embryo rate. The causal effect estimation model for sperm DFI revealed that reducing sperm DFI could increase the high-quality embryo rate. The causal effect estimation model for male weight demonstrated that being overweight can reduce the high-quality embryo rate.

Reducing sperm DFI levels, weight loss, and treating mycoplasma infection are effective methods for improving the high-quality embryo rate in male infertility.

Breastfeeding offers substantial health benefits; however, many mothers discontinue early, particularly after returning to work. This study examined the associations between awareness of breastfeeding benefits, workplace support, and breastfeeding duration, with a focus on factors associated with breastfeeding beyond 6 months.

A cross-sectional study was conducted among 608 employed mothers at a Taiwanese electronics company, which was equipped with certified lactation rooms. The questionnaire collected data on demographics, employment characteristics, breastfeeding behavior after returning to work, perceptions of workplace support, and awareness of breastfeeding benefits.

While 91.3% of participants breastfed during maternity leave, 49.2% discontinued breastfeeding upon returning to work. After returning to work, 23.5% of participants continued breastfeeding for 1–6 months, and 27.3% for more than 6 months. Access to lactation rooms and the ability to take breast-pumping breaks were associated with higher rates of both short-term (1–6 months) and long-term (beyond 6 months) breastfeeding. Colleague support (odds ratio [OR] = 2.49, 95% confidence interval [CI] = 1.04–6.09, p = 0.0410) was significantly associated with continued breastfeeding during the first 6 months after returning to work, but not with breastfeeding beyond 6 months. Participants who agreed that taking breast-pumping breaks would help continue breastfeeding (OR = 6.84, 95% CI = 1.06–48.79, p = 0.0481) were more likely to persist in breastfeeding beyond 6 months. Additionally, greater awareness of the benefits of breastfeeding was associated with a higher likelihood of breastfeeding beyond 6 months compared to 1–6 months (OR = 1.10, 95% CI = 1.01–2.00, p = 0.0390).

This study identified associations between workplace support, awareness of breastfeeding benefits, and breastfeeding duration among employed mothers. Although awareness of breastfeeding benefits was associated with continued breastfeeding after returning to work, workplace support—such as access to lactation rooms, breast-pumping breaks, and social support—was more strongly associated with longer breastfeeding duration. As a retrospective survey, this study may be subject to recall bias. Future prospective research is recommended to further explore these relationships.

The relationship between gut microbiota and red blood cell folate levels in preeclampsia remains unclear. This study aimed to assess the differences in red blood cell folate levels and gut microbiota between pregnant women diagnosed with preeclampsia and healthy pregnant women and to investigate the association between gut microbiota composition and red blood cell folate concentrations.

We employed a case-control study to investigate gut microbiota composition and red blood cell folate levels in preeclampsia, as well as the correlation between them. 10 pregnant women diagnosed with preeclampsia and 16 healthy pregnant women were recruited, and whole blood and stool samples were collected from all participants. For the blood samples, levels of total folate, 5-methyltetrahydrofolate, 5,10-methylenetetrahydrofolate, erythrocyte unmetabolized folate, and 5-formyltetrahydrofolate in red blood cells were measured utilizing high-performance liquid chromatography coupled with tandem mass spectrometry in Multiple Reaction Monitoring (MRM) mode. Microbial diversity in fecal samples was analyzed by 16S rRNA sequencing. The correlation between the microbiota α-diversity and red blood cell folate levels was calculated through Pearson correlation analysis.

There were no statistically significant differences in age, gestational age at the time of specimen collection, or body mass index between the preeclampsia group and the control group (all p > 0.05). Compared to the control group, the preeclampsia group showed significantly lower levels of total folate in red blood cells (p < 0.001), 5-methyltetrahydrofolate (p = 0.001), and 5,10-methylenetetrahydrofolate (p = 0.002). However, there were no differences in the levels of 5-acyltetrahydrofolate (p = 0.816) and unmetabolized folate (p = 0.241) in red blood cells between the two groups. Statistical analysis revealed significant differences between the two groups in several α-diversity indices of the gut microbiota, including the abundance-based coverage estimator (ACE) index (p = 0.011), Chao1 index (p = 0.010), PD_whole_tree index (p = 0.046), Shannon index (p = 0.015), and Simpson index (p = 0.043). These findings highlight notable differences in microbial diversity between the groups. The β-diversity analysis demonstrated significant compositional differences in the gut microbiota between samples, which were evident across multiple taxonomic ranks, including phyla, classes, orders, families, genera, and species. The Pearson correlation analysis revealed that levels of total folate, 5-methyltetrahydrofolate, and 5,10-methylenetetrahydrofolate in red blood cells were significantly associated with the α-diversity of gut microbiota.

Significant changes in erythrocyte folate level and intestinal microbiota diversity were observed in preeclampsia patients. Based on the limited data, the results of the Pearson correlation analysis indicate a significant association between red blood cell folate levels and gut microbiota diversity. However, this association should be interpreted with caution.

Kisspeptin, a key regulator of the hypothalamic-pituitary-ovarian (HPO) axis through GnRH stimulation, is implicated in polycystic ovary syndrome (PCOS) pathogenesis via HPO axis dysregulation. Although follicular kisspeptin levels predict success in fresh IVF cycles, their prognostic value in PCOS patients undergoing frozen-thawed embryo transfer (FET) cycles remains unknown. This study investigated the correlation between serum kisspeptin levels on the day of embryo transfer and pregnancy outcomes in patients with PCOS undergoing FET cycles.

80 PCOS patients undergoing their first FET cycle were prospectively enrolled. Patients were divided into three groups based on the tertiles of serum kisspeptin levels on the day of embryo transfer. The relationship between serum kisspeptin levels and pregnancy outcomes was analyzed. Multivariate logistic regression analysis was conducted to adjust for potential confounders, and a restricted cubic spline model was employed to examine the dose-response relationship between kisspeptin levels and pregnancy outcomes.

There were no significant differences in baseline characteristics among the three groups, except for the basal follicle-stimulating hormone level (p < 0.001). Significant differences were observed among the three groups in terms of live birth rate, pregnancy rate, and clinical pregnancy rate. Multivariate logistic regression analysis revealed that the odds of live birth were significantly higher in the third tertile (T3) group (highest kisspeptin levels) than in the first tertile (T1) group (lowest kisspeptin levels). Restricted cubic spline analysis showed a significant dose-response relationship between serum kisspeptin levels and pregnancy outcomes. Additionally, serum kisspeptin levels were positively correlated with progesterone levels on the day of embryo transfer day, whereas no significant correlation was observed with estradiol levels.

In PCOS patients undergoing frozen-thawed embryo transfer cycles, higher serum kisspeptin levels were associated with improved pregnancy outcomes, suggesting that kisspeptin may serve as a useful biomarker for predicting pregnancy success.