Evidence map›Paper›PMID 41501838›Full record

ArticleJournal of ovarian research2026

Investigating the association between systemic immune-inflammation index and female fertility: a retrospective cohort study.

Quan-Zi Yao, Rui-Ling Liu, Yi-Yan Zeng, Xing-Yu Lv, Li-Hong Geng, Yu-Ling Hu, Jia-Liang He, Zhi-Lei Xu, Li-Juan Fu, Mei-Hua Bao and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of ovarian research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Quan-Zi Yao *Department of Obstetrics and Gynecology, Department of Epidemiology, Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Women and Children's Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 401147, China.
Rui-Ling Liu *Department of Obstetrics and Gynecology, Department of Epidemiology, Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Women and Children's Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 401147, China.
Yi-Yan ZengDepartment of Obstetrics and Gynecology, Department of Epidemiology, Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Women and Children's Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 401147, China.
Xing-Yu LvThe Reproductive Center, Sichuan Jinxin Xinan Women & Children's Hospital, Chengdu, Sichuan, 610011, China.
Li-Hong GengThe Reproductive Center, Sichuan Jinxin Xinan Women & Children's Hospital, Chengdu, Sichuan, 610011, China.
Yu-Ling HuThe Reproductive Center, Sichuan Jinxin Xinan Women & Children's Hospital, Chengdu, Sichuan, 610011, China.
Jia-Liang HeDepartment of Obstetrics and Gynecology, Department of Epidemiology, Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Women and Children's Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 401147, China.
Zhi-Lei XuDepartment of Obstetrics and Gynecology, Department of Epidemiology, Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Women and Children's Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 401147, China.
Li-Juan FuDepartment of Pharmacology, Chongqing Key Laboratory of Traditional Chinese Medicine for Prevention and Cure of Metabolic Diseases, School of Traditional Chinese Medicine, Chongqing Medical University, Chongqing, 400016, China.
Mei-Hua BaoDepartment of Pharmacology, Academician Workstation, Changsha Medical University, Changsha, 410219, China.
Tian LiThe Reproductive Center, the First Affiliated Hospital of Chongqing Medical Univesity, Chongqing, 400016, China.
Zhao-Hui ZhongDepartment of Obstetrics and Gynecology, Department of Epidemiology, Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Women and Children's Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 401147, China.
Yu-Bin DingDepartment of Obstetrics and Gynecology, Department of Epidemiology, Joint International Research Laboratory of Reproduction and Development of the Ministry of Education of China, School of Public Health, Women and Children's Hospital of Chongqing Medical University, Chongqing Medical University, Chongqing, 401147, China. dingyb@cqmu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInflammation has been linked to female fertility, yet its impact on ovarian reserve and response remains unclear. This study investigates the associations between systemic inflammatory markers, ovarian reserve—assessed by anti-Müllerian hormone (AMH) and antral follicle count (AFC)—and ovarian response, measured by the number of oocytes retrieved, in women undergoing assisted reproductive treatment (ART).

methodsA retrospective cohort study of 19,282 women evaluated systemic inflammatory markers, including systemic immune-inflammation index (SII), platelet-neutrophil product (PPN), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR), derived from neutrophil, platelet, and lymphocyte counts. Blood samples were collected on menstrual cycle days 2–4 for complete blood count analysis. Linear regression assessed associations between inflammatory markers and ovarian reserve (AMH, AFC) or ovarian response (oocytes retrieved). Restricted cubic splines tested nonlinear relationships, and stratified analyses identified sensitive subpopulations.

resultsElevated first-trimester systemic inflammatory markers, including SII, PPN, PLR, and NLR, were significantly associated with reduced ovarian reserve and ovarian response. Adjusted models confirmed dose-response declines: highest vs. lowest quartiles showed significant reductions in AMH (e.g., SII β=-0.037, 95% CI -0.055, -0.018), AFC (e.g., NLR β=-0.116, 95% CI -0.150, -0.082), and oocytes retrieved (e.g., PPN β=-0.072, 95% CI -0.106, -0.039) (all P < 0.05). Nonlinear relationships were observed for PLR and NLR with AFC (inflection points at PLR = 123.53, NLR = 2.22; P nonlinear < 0.05). Stratified analyses indicated greater susceptibility in women on antagonist protocols (P interaction < 0.05), but not by age or BMI. Sensitivity analyses corroborated robustness.

conclusionElevated systemic inflammatory markers are associated with diminished ovarian reserve and response. These findings suggest that inflammatory markers may serve as potential predictors of ovarian function and treatment outcomes, emphasizing the need to address systemic inflammation in fertility care.

Indexed as

FertilityInflammationAdultAnti-Mullerian HormoneBiomarkersFemaleHumansOvarian ReserveRetrospective StudiesAnti-Mullerian HormoneBiomarkersFertilityOvarian reserveOvarian responseSystemic immune-inflammation index

Identifiers

PMID41501838
PMCPMC12870993

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.