Evidence mapPaperPMID 42219496Full record

ArticleJournal of ovarian research2026

HOMA-IR partially mediates the association between percent appendicular skeletal muscle mass and IVF/ICSI outcomes.

Danyu Ni, Xinyu Wang, Zichen Zheng, Kaidi Yu, Qijun Xie, Chun Zhao, Xiufeng Ling, Ye Yang

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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. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Danyu NiDepartment of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, China.
Xinyu WangDepartment of Obstetrics and Gynecology, Suzhou Ninth People's Hospital, Suzhou, China.
Zichen ZhengDepartment of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, China.
Kaidi YuDepartment of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, China.
Qijun XieDepartment of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, China.
Chun ZhaoDepartment of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, China. zhaochun2008@yeah.net.
Xiufeng LingDepartment of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, China. lingxiufeng_njfy@163.com.
Ye YangDepartment of Reproductive Medicine, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, China. yeyang89@njmu.edu.cn.

Funding

National Key Research and Development Program of China 2022YFC2702201National Natural Science Foundation of China 82171645National Natural Science Foundation of China 82301874National Natural Science Foundation of China 82371670
6 · The paper itself

Abstract

backgroundSkeletal muscle mass contributes to metabolic health, particularly in relation to insulin sensitivity, and both skeletal muscle mass and metabolic health may influence outcomes after assisted reproductive technology (ART). However, whether insulin sensitivity partially explains the association between skeletal muscle mass and ART outcomes remains unclear. This study aimed to investigate the association between the percentage of appendicular skeletal muscle mass (PASM) and outcomes from in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) and to explore whether insulin resistance, assessed by HOMA-IR, partially mediates this association.

methodsThis retrospective study included 990 patients who underwent IVF/ICSI at Nanjing Medical University from April 2022 to April 2023. PASM was measured by bioelectrical impedance analysis (BIA) and analysed both as quartiles and as a continuous variable. Insulin sensitivity was assessed using the homeostatic model assessment of insulin resistance (HOMA‑IR). We employed Spearman's correlation analysis, multivariate regression, restricted cubic spline (RCS) models, and mediation analysis with adjustment for relevant confounders.

resultsUnadjusted comparisons showed only non-significant increasing trends across PASM quartiles, whereas adjusted regression analyses indicated more favourable laboratory outcomes in higher PASM quartiles. Each 1-unit increase in PASM was associated with the number of oocytes retrieved (Beta = 0.29), available embryos (Beta = 0.25) and blastocysts (Beta = 0.21), as well as higher available embryo rate (Beta = 1.49) and blastocyst formation rate (Beta = 1.52). PASM was positively linked to cumulative clinical pregnancy rate (CCPR) (OR = 1.30). Higher PASM was inversely associated with HOMA‑IR and insulin resistance (IR) prevalence; elevated HOMA‑IR was independently associated with poorer embryology laboratory indicators (P < 0.05). Mediation analysis suggested that HOMA-IR modestly mediated 5.5%, 5.9%, and 7.3% of the associations between PASM and the number of oocytes retrieved, available embryos and blastocysts, respectively.

conclusionsHigher PASM was associated with more favourable embryology laboratory indicators and higher pregnancy success after IVF/ICSI, with HOMA-IR showing partial and modest mediation. Interventions targeting skeletal muscle mass may represent a potential strategy for optimizing assisted reproduction outcomes, pending confirmation in prospective studies.

Indexed as

Fertilization in VitroInsulin ResistanceMuscle, SkeletalSperm Injections, IntracytoplasmicAdultFemaleHumansPregnancyRetrospective Studieshomeostatic model assessment of insulin resistance (HOMA‑IR)insulin sensitivityin vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI)Percent appendicular skeletal muscle mass (PASM)

Identifiers

PMID42219496
PMCPMC13436113

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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 Socratic graph.