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Elevated triglyceride glucose-body mass index is associated with a higher risk of reduced cumulative live birth and adverse pregnancy outcomes in women undergoing assisted reproductive technology: a retrospective cohort study

Hu J, Ma S, Gao Y, Peng Y, Wang X, Wu IXY, Gong F

Frontiers in endocrinology, 2026

53,393 participants

Abstract

Background: Insulin resistance has been linked to adverse reproductive and pregnancy outcomes. The triglyceride glucose-body mass index (TyG-BMI) serves as a simple and cost-effective surrogate marker of insulin resistance. This study aimed to investigate the association between maternal TyG-BMI and cumulative live birth as well as pregnancy outcomes in women undergoing assisted reproductive technology.

Methods: This retrospective cohort study included 53,393 women undergoing assisted reproductive technology at the Reproductive and Genetic Hospital of CITIC-Xiangya, China, between January 1, 2017, and March 31, 2023. Associations between baseline TyG-BMI and assisted pregnancy outcomes were estimated using modified Poisson regression and restricted cubic splines.

Results: A significant linear inverse association was observed between TyG-BMI and cumulative live birth rate (P-overall = 0.029). Compared with women in the lowest TyG-BMI tertile (≤177), those in the highest tertile (>203) had a lower cumulative live birth rate (aRR 0.973; 95% confidence interval 0.956-0.991). Higher TyG-BMI was also associated with higher risks of first-trimester miscarriage (aRR, 1.090; 95% confidence interval 1.002-1.185), second- or third-trimester fetal loss (aRR 1.694; 95% confidence interval 1.481-1.938), preterm birth (aRR 1.244; 95% confidence interval 1.170-1.323), and macrosomia (aRR 2.352; 95% confidence interval 2.060-2.685).

Conclusions: Higher maternal TyG-BMI is associated with…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 53,393 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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