ORIGINAL RESEARCH article
Front. Reprod. Health
Sec. Assisted Reproduction
Predictive Value of Hematological Parameters for IVF Success: A Retrospective Analysis
Provisionally accepted
Fatma Tulucu Kalkan1
Ufuk Atlihan2*Gökçe Aykanat3
Begum Ertan4
Ferruh Acet5Ege Nazan Tavmergen Goker6
Erol Tavmergen6- 1TC Saglik Bakanligi Gaziantep Sehir Hastanesi, Şahinbey, Türkiye
- 2Dokuz Eylül University, Alsancak, Türkiye
- 3Kınık state hospital, izmir, Türkiye
- 4Akhisar State Hospital, Manisa, Türkiye
- 5Tavmergen IVF Clinic, izmir, Türkiye
- 6Ege Universitesi Tip Fakultesi, Izmir, Türkiye
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Objective: To evaluate the predictive value of hematologic inflammatory indices derived from complete blood count (CBC) parameters for in vitro fertilization (IVF) outcomes in women with unexplained infertility, and to determine their potential role as biomarkers of subclinical inflammation affecting reproductive success. Materials and Methods: This retrospective cohort study included 430 women with unexplained infertility who underwent IVF/ICSI cycles at Ege University Hospital between January 2020 and January 2025. CBC parameters and derived systemic inflammatory indices— including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV)—were measured on the ovulation trigger day. Patients were divided into pregnant and non-pregnant groups according to clinical pregnancy outcomes. Demographic, hormonal, hematologic, and embryologic variables were compared using appropriate statistical tests, and logistic regression and ROC analyses were performed to identify independent predictors of pregnancy. Results: None of the CBC-derived inflammatory indices showed significant differences between pregnant and non-pregnant groups (all p > 0.05). ROC analysis revealed poor discriminative ability for predicting pregnancy (AUC values 0.48–0.52). In contrast, embryologic variables—particularly the number of two-pronuclei (2PN) embryos and total embryos—were independent predictors of clinical pregnancy (p < 0.05), while excessive oocyte yield was inversely associated with pregnancy (p = 0.028). Conclusion: Systemic inflammatory indices derived from CBC parameters, including NLR, PLR, MLR, SII, SIRI, and PIV, do not predict IVF/ICSI outcomes in women with unexplained infertility. Embryologic parameters, especially 2PN and total embryo counts, remain the most reliable predictors of clinical pregnancy.
Keywords: Embryo quality, Hematologic indices, Inflammation, IVF, Neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, Unexplained infertility
Received: 15 Nov 2025; Accepted: 01 Dec 2025.
Copyright: © 2025 Tulucu Kalkan, Atlihan, Aykanat, Ertan, Acet, Tavmergen Goker and Tavmergen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ufuk Atlihan
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