Objective: To explore the effect of
dyslipidemia on the clinical outcome of intracytoplasmic sperm injection-embryo transfer (ICSI-ET) in
infertility patients receiving donor eggs. Methods: A total of 118 patients were selected to receive egg donors and ICSI-ET at the First Affiliated Hospital of Nanjing Medical University between April 2007 and December 2020. According to the levels of
triacylglycerol, serum
cholesterol,
high density lipoprotein (HDL), and
low density lipoprotein, they were divided into
dyslipidemia group (35 cases) and normal blood
lipids group (83 cases). The influence of body mass index (BMI) and age was adjusted by 1∶1 propensity score matching, and the general condition and clinical outcome of the two groups were analyzed retrospectively. Finally, the relationship between
lipid composition and clinical outcome was analyzed according to patients' age and BMI. Results: (1) Comparing the pre-matching
dyslipidemia group with the normal blood
lipids group, the BMI of the
dyslipidemia group was significantly higher than that of the normal blood
lipids group [(23.5±2.4) vs (22.4±2.7) kg/m2], and the embryo implantation rate was significantly lower than that of the normal blood
lipids group [13.6% (8/59) vs 27.3% (36/132)], the differences were statistically significant (both P<0.05). (2) There were no significant differences in years of
infertility, number of pregnancies, number of abortions, number of transplanted embryos, protocol of endometrial preparation, endometrial thickness on
transplantation day and high quality embryo rate between the two groups, through propensity score matching (all P>0.05). The biochemical pregnancy rate [28.6% (10/35)], embryo implantation rate [13.6% (8/59)] and live birth rate [20.0% (7/35)] in
dyslipidemia group were significantly lower than those in the normal blood
lipids group (P<0.05). The clinical pregnancy rate was lower than that of the normal blood
lipids group (P>0.05). (3) The results of stratified analysis showed that the level of HDL in the clinically non-pregnant group was significantly lower than that in the pregnant group in patients ≤ 35 years old [(1.5±0.3) vs (1.8±0.5) mmol/L; P<0.05]. In the
overweight recipient patients, the level of HDL of the clinically non-pregnant group was lower than that of the pregnant group (P>0.05). Conclusions:
Dyslipidemia significantly reduces the biochemical pregnancy rate, embryo implantation rate and live birth rate in patients with receiving donor eggs. Especially in patients aged ≤35 years old, the reduction of HDL is closely related to adverse pregnancy outcomes.