Optimizing cryo-resuscitation from frozen sperm would improve access to cryopreserved rat models. In this study, the possibility of replacing intracytoplasmic sperm injection (ICSI) with in vitro fertilization (IVF) for model cryo-resuscitation from frozen-thawed sperm was investigated. Rat IVF protocol was modified to allow the procedures to be performed during a 9 h workday. The possibility of genetic background-specific modification of the superovulation protocol for the improvement in IVF outcomes was explored. Wild-type and genetically modified Sprague Dawley (SD), Long Evans (LE) and Fischer 344 (F344) rats were used. Sperm freezing and IVF were conducted as previously described. Cleavage, blastocyst formation and hatching of the resulting embryos were used to assess their developmental potential in vitro. The results showed that, with limited repetitions, current sperm freezing and IVF protocols resulted in cleavage rates ranging from 58 ± 11% to 87 ± 7% and blastocyst rates ranging from 21 ± 25% to 54 ± 23%, which are acceptable for the cryo-resuscitation of rat models. With slight modifications, the procedure can be fit into a 9 h workday (SD: 48 ± 35%; F344: 36 ± 13%). Strain/stock-specific differences in oocyte maturation timing were observed: LE females had a two-hour delay compared to SD and F344 rats in response to the same superovulation protocol. However, modifying the protocol for LE rats did not significantly improve IVF outcomes (34 ± 6 vs. 32 ± 12%). Overall, while IVF with frozen-thawed sperm is a promising alternative to ICSI, significant variability remains across strains/stocks and protocols. Continued research is necessary to advance our understanding of factors affecting the efficiency and repeatability of rat sperm freezing and IVF.

The couples' distinct effects of metals exposure on intermediate and pregnancy outcomes of in vitro fertilization treatment: A prospective cohort study.

Paternal preconception urinary concentrations of bisphenol A and F in relation to in vitro fertilization outcomes: A prospective cohort study.

Infertility refers to a couple's inability to conceive after a period of normal, unprotected sexual activity or to carry a pregnancy to full term. This study investigated the correlation between sperm DNA fragmentation index (DFI) and routine semen parameters, as well as its predictive value for in vitro fertilization (IVF) outcomes. A total of 158 infertile patients undergoing IVF-embryo transfer (ET) from September 2021 to February 2023 were enrolled. Based on DFI levels, patients were divided into a low-DFI group (DFI ≤ 25%, n=94) and a high-DFI group (DFI > 25%, n=64). Routine semen parameters were analyzed and correlated with DFI levels. DFI showed significant negative correlations with sperm motility, progressive motility (PR), and non-progressive motility (NP), and a positive correlation with immotility (IM) (P<0.05).Receiver operating characteristic (ROC) analysis revealed that combined semen parameters had the highest diagnostic value for assessing DFI (AUC = 0.998). Additionally, significant differences were observed between groups in human chorionic gonadotropin (hCG) positivity and clinical pregnancy rates (P<0.05). We conclude that sperm DFI is negatively associated with sperm motility parameters and positively associated with immotility. .It has a predictive value for clinical IVF outcomes and may serve as a useful indicator in infertility assessment.

In-vitro-fertilization (IVF) failure rates remain above 65% with unknown causes. Uterine receptivity, largely determined by uterine peristalsis, is believed to play a key role in the IVF success. Accurate assessment of uterine peristalsis holds the potential for improving the success rate of embryo implantation. This prospective study includes 62 IVF patients from multiple fertility centers under three different clinical settings. Four-minute B-mode transvaginal ultrasound (TVUS) scans were performed one hour before embryo transfer (ET). 25 features related to frequency, amplitude, power, velocity, and coordination were extracted using strain analysis from TVUS speckle tracking results. Three probabilistic classifiers, i.e., support vector machine (SVM), K-nearest neighbors (KNN), and adaptive boosting (AdaBoost), were employed to discriminate uterine activity as either favorable or adverse to clinical pregnancy rate. Prior to machine learning, feature selection was performed by categorized feature ranking and sequential forward selection. The proposed method was evaluated by a nested 8-fold cross validation. Results: Our results suggest that features related to coordination and frequency of the uterine peristalsis are strongly associated with clinical pregnancy. SVM demonstrates the best classification performance between successful and unsuccessful pregnancies, with an average area under the ROC curve of 0.81. We developed a machine learning framework to improve the prediction of IVF outcome based on multi-center TVUS recordings. Our SVM model identified significant uterine motion features and demonstrated reliable and generalizable classification performance. This work can provide useful means to support clinicians for clinical decision-making prior to ET and possibly enhance IVF success rates.

Recurrent implantation failure (RIF) is a multifactorial reproductive disorder, often associated with chronic endometritis (CE) and alterations of the intrauterine microbiota. This systematic review evaluated whether microbiota-targeted therapeutic interventions improve pregnancy outcomes in women with CE-associated RIF undergoing invitro fertilization (IVF)-embryo transfer (ET). Study quality and risk of bias were assessed using the Newcastle-Ottawa Scale (NOS) and the Revised Cochrane Risk of Bias in Non-Randomized Studies - of Interventions (ROBINS-I). Four studies met the inclusion criteria, encompassing antibiotic, probiotic, and nutraceutical interventions. Considerable heterogeneity was observed in study design, diagnostic criteria, and microbiota assessment methods. Across studies, the reproductive outcomes revealed a clinical pregnancy rate of 50.5% (187/370), ongoing pregnancy rate of 40.1% (107/267), and live birth rate of 41.2% (105/255). Other reported outcomes included seven multiple pregnancies (8.3%), 39 miscarriages (20.0%), 35 biochemical pregnancies (17.9%), and one stillbirth (1.17%). Microbiota-targeted treatments may improve reproductive outcomes in women with CE-associated RIF; however, the limited number of available studies, small sample sizes, and methodological variability reduce the strength of current evidence. High-quality, prospective, confounder-adjusted trials with rigorous participant selection processes and standardized, validated diagnostic and implementation criteria are needed to confirm these findings and inform clinical practice.

In Vitro Fertilization Utilization Rates and Outcomes in States With and Without Insurance Coverage Mandates for Male Infertility Care.

BackgroundThe clinical impact of sperm chromatin condensation defects (SCCD) on in vitro fertilization (IVF) outcomes remains controversial. This study aimed to clarify the effects of SCCD on embryonic development, pregnancy, and neonatal outcomes in couples undergoing their first IVF cycle.MethodsThis retrospective cohort study included 647 couples. Multivariable logistic regression was used to evaluate associations between SCCD (assessed by aniline blue staining) and clinical outcomes, with stratification and generalized additive models employed to identify effect modifiers and nonlinear relationships.ResultsElevated SCCD levels (≥30%) were correlated with abnormal conventional semen parameters and a reduced two-pronuclei (2PN) cleavage rate, whereas no significant associations were observed with spontaneous abortion, gestational age, birth weight, or neonatal sex distribution. After adjusting for key confounders, increasing SCCD levels remained independently associated with reduced clinical pregnancy (OR = 0.98, P = 0.01) and live birth rates (OR = 0.98, P = 0.02), and no significant effect modification by any subgroup variable was observed (all P for interaction > 0.05). Moreover, individuals with SCCD levels ≥30% showed a trend toward substantially reduced clinical pregnancy (OR = 0.64, P = 0.05) and live birth rates (OR = 0.65, P = 0.06). Nonlinear analysis further identified a significant risk threshold for live birth at 10.6% (OR = 0.86, P = 0.01), with risk plateauing until a declining trend emerged beyond 24.1%.ConclusionsThis study provides evidence that SCCD is independently associated with reduced IVF success, supporting its assessment in pre-IVF evaluation.

ObjectivePrior to in vitro fertilization (IVF), physicians can choose either recombinant or urine-derived follicle-stimulating hormone (FSH) for ovarian stimulation. The common polymorphism N680S (rs6166) in the follicle-stimulating hormone receptor (FSHR) has been linked to individual variability in ovarian response to FSH stimulation and IVF outcomes, including live birth rates, highlighting its potential value in optimizing stimulation protocols. However, classical genotyping is laborious, often requiring blood as starting material and specialized laboratories for analysis. The aim of the study was to develop a system for rapid and easy-to-use genotyping of the FHSR N680S variant.MethodsThe assay constituted an allele-specific peptide nucleic acid-mediated loop-mediated isothermal amplification (AS PNA-mediated LAMP) assay with a colorimetric detection system. The analytical performance was analyzed with naked-eye detection and verified with fluorescence amplification. Clinical validation was assessed on 50 patients visiting an IVF-clinic in whom the variant was confirmed with Sanger sequencing.ResultsNinety-one out of 100 samples were genotyped correctly, demonstrating 91% overall accuracy. Clinical sensitivity reached 86.8 [95% Cl 76.4-93.8%], while specificity was 100% [95% Cl 89.1-100%]. The test was performed by trained laboratory staff in less than one hour.ConclusionThe LAMP assay provides a rapid and user-friendly genotyping of the FSHR N680S, which makes it a valuable tool in point-of-care settings, where it may help guide treatment options prior to IVF.

The aim of this study was to evaluate whether chronological age or ovarian reserve exerts a greater influence on in vitro fertilization (IVF) outcomes. A retrospective cohort analysis was conducted, including 108 women undergoing IVF at In vitro OG Medical Centre Dimitrov between 2018 and 2024. Participants were classified as OLDER NOR (age &gt; 35 years, AMH ≥ 1.5 ng/ml) and YOUNG DOR (age ≤ 35 years, AMH ≤1.1 ng/ml). Although women in the OLDER NOR cohort exhibited higher AMH levels, younger women with diminished ovarian reserve achieved better clinical outcomes – higher fertilization, clinical pregnancy, and live birth rates. These findings suggest that chronological age has a stronger impact on embryo competence and implantation potential than ovarian reserve markers alone, highlighting the predominant role of age in determining reproductive success in IVF cycles.

Infertility, defined as the inability to conceive after 1 year of unprotected intercourse, affects 15% of couples globally and is a significant source of psychological distress, especially in women undergoing in vitro fertilization (IVF). This study investigates whether psychotherapeutic interventions reduce distress and improve embryo implantation rates in IVF patients. A randomized controlled trial was conducted at two IVF centers in Chandigarh Tricity, India, between June 2023 and April 2024. Three hundred women, aged 21-45 years, were assigned to an experimental and a control group. The experimental group received a structured four-session psychotherapeutic intervention targeting stress, uncertainty, and anxiety, measured using validated scales before and after the intervention. Embryo implantation rates were also recorded. Data collection was followed by entry into Excel and analysis with IBM SPSS 27. Compared to the control group, the experimental group showed significant reductions in stress, anxiety, and uncertainty. Embryo implantation was successful in 71.3% of the experimental group and 52.7% of the control group (P = 0.001). The intervention also significantly lowered state and trait anxiety (P < 0.001). Structured psychotherapeutic intervention effectively reduced psychological distress and improved IVF outcomes. These results suggest that psychotherapeutic support should be integral to IVF treatment for better emotional well-being and clinical success.

Background: The success of in vitro fertilization (IVF) is influenced by multiple patient- and laboratory-related factors, including maternal age, body mass index (BMI), ovarian stimulation, and embryo quality. Laboratory illumination may induce photo-oxidative stress, potentially impairing embryo development and implantation. This study evaluated the clinical impact of introducing a light-protection protocol in an IVF laboratory. Methods: We retrospectively analyzed 2125 IVF cycles with fresh embryo transfer performed at the Assisted Reproduction Centre of the University of Pécs between 1 March 2016 and 30 November 2020. A light-protection protocol was implemented on 1 March 2017, while all other laboratory and clinical parameters remained unchanged. Pregnancy outcomes before and after implementation were compared, with additional subgroup analyses focusing on cycles with low blastocyst-formation rates. Results: After implementation of light protection, overall pregnancy rates increased by approximately 5%; however, this difference was not statistically significant. In contrast, subgroup analyses demonstrated a markedly greater improvement in pregnancy outcomes-up to 37%-in cycles characterized by low blastocyst-formation rates. Conclusions: Although light protection did not significantly improve overall pregnancy rates, the findings suggest a clinically relevant benefit in selected cases with reduced embryonic developmental competence. Minimizing photo-oxidative stress may therefore represent a targeted laboratory intervention to improve IVF outcomes in vulnerable embryo populations.

Aims: Cytochrome C (Cyt C) is a small heme protein located in the mitochondria, playing a dual and crucial role in cellular physiology as cellular respiration and apoptosis. This study aimed to investigate Cyt C gene expression in spent embryo culture fluid (SECF) as a non-invasive biomarker for distinguishing between Normoresponder (NOR), Early-Diminished Ovarian Reserve (E-DOR), Advanced-Diminished Ovarian Reserve (A-DOR), and polycystic ovarian syndrome (PCOS) patients undergoing in vitro fertilization (IVF). Methods: SECF samples were collected from patients at Bahçeci Health Group Umut IVF Laboratory, İstanbul, with informed consent and ethical approval (2023/19-22). Forty-eight samples from each group (NOR, E-DOR, A-DOR, PCOS) were analyzed. Ovarian stimulation followed an antagonist protocol, and embryos were cultured individually. On day 3, embryos were morphologically graded. Total RNA was isolated from SECF, converted to cDNA, and Cyt C gene expression was quantified using RT-PCR, with GAPDH as an internal control. Statistical analyses included the Kolmogorov-Smirnov and Shapiro-Wilk tests for normality, Sidak for multiple comparisons, and the Pearson correlation test for group relationships. Results: Compared to NOR samples, Cyt C gene expression was significantly upregulated in A-DOR samples, while E-DOR samples showed downregulation (p&lt;0.001). No statistical difference was observed between NOR and PCOS samples (p&gt;0.05). Pearson correlation revealed a significant relationship only between NOR and A-DOR SECF samples (r&lt;0.01). Conclusion: These findings suggest that Cyt C expression in SECF can differentiate between early and advanced stages of diminished ovarian reserve, with age-related differences in apoptosis mechanisms. PCOS cases, characterized by a high quantity but low quality of oocytes, showed no significant variation in Cyt C expression, likely due to less active apoptotic pathways. Monitoring Cyt C in SECF may provide a valuable, non-invasive tool for assessing embryo quality and optimizing IVF outcomes. Further research is needed to validate these findings and establish clinical protocols.

ObjectiveWe aimed to analyze the correlation between the neutrophil-to-lymphocyte ratio (NLR), and the treatment outcomes for infertile women after in vitro fertilization (IVF) using embryo transfer technology.MethodsThis retrospective study enrolled women with infertility at Huzhou Maternal and Child Health Care Hospital who underwent in vitro IVF procedures. Patient data were collected from a reproductive electronic medical record system. We divided 976 participants into positive and negative groups based on embryo availability after IVF. Age, education level, body mass index, infertility type, etiology, miscarriage history, ovarian stimulation protocols, baseline follicle stimulating hormone levels, anti-Müllerian hormone and NLR were compared in both groups. We investigated the association between NLR and IVF outcomes using logistic regression analysis with multi-model adjustments. The receiver operating characteristic (ROC) curve was used to evaluate the screening efficacy of NLR, The subgroup analysis revealed risk variations among different groups. Finally, we performed sensitivity analysis by modifying control values and conducting logistic regression using NLR quartiles.ResultsMultimodal adjusted logistic regression analysis revealed a significant association between the second quartile of NLR and negative outcomes of IVF treatment, with an OR value and 95% confidence interval of 0.28 (0.10-0.67). The area under the ROC curve was 0.850 <. We observed an interaction between NLR quartiles and infertility types, particularly positive correlations between primary infertility, female-specific infertility factors, and no history of miscarriage with IVF outcomes at the second quartile. When the second quartile was adjusted as a reference value, the three remaining quartiles exhibited statistically significant differences compared to the second quartile (p for trend = 0.045).ConclusionWe recommended dynamically monitoring NLR during the cycle of ovulation induction and advocating individualized inflammatory management based on the cause of infertility to ensure the effectiveness of IVF treatment and prevent resource wastage.

Background and Objectives: Klotho (KL) is a multifunctional protein involved in reproductive physiology; however, its precise role in ovarian reserve and in vitro fertilization (IVF) outcomes remains unclear. This study aimed to evaluate the relationship between follicular fluid KL levels, ovarian reserve markers, and key IVF success parameters. Materials and Methods: This prospective study included a total of 150 women undergoing IVF, of whom 82 had diminished ovarian reserve (DOR) and 68 had normal ovarian reserve (NOR). All participants underwent controlled ovarian stimulation using a standard antagonist protocol. During oocyte pick-up (OPU), the first aspirated follicular fluid sample was collected, processed, and analyzed for KL concentrations using a Human Klotho ELISA kit. Hormonal profiles, ovarian reserve markers, and IVF outcomes were compared between groups. Results: Follicular fluid KL levels were significantly lower in the DOR group compared with the NOR group (117.07 ± 28.88 pg/mL vs. 266.13 ± 58.29 pg/mL; p < 0.001). Anti-Müllerian hormone (AMH) levels were reduced, whereas follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels were significantly higher in the DOR group (all p < 0.001). Implantation and clinical pregnancy rates were also significantly lower in the DOR group compared with the NOR group (p < 0.001 and p = 0.003, respectively). KL levels showed a strong positive correlation with the number of fertilized oocytes in both groups (DOR: r = 0.690; NOR: r = 0.552). Each one-unit increase in KL was associated with a 3.7% increase in implantation probability and a 3.2% increase in clinical pregnancy probability in the DOR group, and with corresponding increases of 4.4% and 1.2% in the NOR group (all p < 0.05). Conclusions: This study demonstrates significant associations between follicular fluid KL levels and fertilization, implantation, and clinical pregnancy outcomes. These associations appear to be more pronounced than those observed with traditional ovarian reserve markers such as AMH and antral follicle count. Reduced KL levels are associated with fewer fertilized oocytes, whereas higher KL concentrations correspond to increased implantation and clinical pregnancy probabilities. Nevertheless, similar to other non-invasive biomarkers, current evidence is insufficient to support routine clinical use of KL. Large-scale, well-designed, multicenter studies are therefore required to validate its clinical relevance and to determine whether KL can serve as a reliable and practical predictor of IVF success.

Associations of urinary N, N-dimethylformamide metabolite concentrations with ovarian reserve and in vitro fertilization outcomes based on a prospective cohort study in China.

To investigate the impact of anti-endometrial antibodies (EMAb) on pregnancy outcomes in infertile patients undergoing in vitro fertilization (IVF) and to assess the potential value of personalized treatment strategies. A total of 47 EMAb-positive and 166 EMAb-negative oocyte retrieval cycles were retrospectively included following propensity score matching (PSM) to control for basic clinical characteristics influencing pregnancy outcomes. The two groups were compared in terms of various aspects closely associated with IVF outcomes. Pregnancy outcomes were assessed based on implantation, clinical pregnancy, miscarriage, and ongoing pregnancy rates. No significant differences were found between the two groups regarding infertility-related clinical characteristics, oocyte- and embryo-related indicators, endometriosis incidence, and so forth. Compared with the EMAb-negative group, the implantation rate in the EMAb-positive group was lower by 10.3 percentage points (p = 0.047), whereas the 8.2-point lower clinical pregnancy rate did not reach statistical significance (p = 0.234). There were no significant differences in ongoing pregnancy and miscarriage rates between the two groups. Our study observed that the presence of EMAb was associated with less favorable IVF outcomes, primarily reflected in lower implantation and clinical pregnancy rates. However, once the implantation was successful, the risk of miscarriage did not increase. These findings suggest a potential role for EMAb screening in guiding personalized treatment strategies, such as increasing the number of embryos transferred or using immunosuppressive agents, to improve IVF outcomes. Future research should involve more extensive and diverse populations to explore the mechanisms of action of EMAb and their impact on IVF treatment outcomes.

Oxidative stress (OS) is a significant challenge in the in vitro embryo culture of patients of advanced age. The Erzhi Tiangui (EZTG) formula has been shown to alleviate OS-induced apoptosis in granulosa cells (GCs) of patients undergoing in vitro fertilization (IVF) cycles. This study aimed to investigate the protective effects and underlying mechanisms of the EZTG formula on OS and apoptosis in GCs of patients with advanced age. A total of 240 patients aged 35 to 42 years were randomly assigned to either the experimental group (EZTG formula) or the control group (placebo). The experimental group received 3g of EZTG formula three times daily, starting from the menstrual period preceding the IVF cycle for approximately 45 days, while the control group received a placebo. The primary outcome measure was the number of high-quality embryos, while secondary outcomes included additional indicators related to oocytes, embryos, and pregnancy outcomes. GCs were collected from advanced-age patients during oocyte retrieval. Nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) are key signaling molecules associated with OS prevention. These molecules potentially link the EZTG formula, OS mitigation, and embryo quality through Nrf2 activation. We examined the protein and mRNA levels of Nrf2/HO-1 and the activities of downstream antioxidant enzymes in GCs to elucidate the underlying mechanisms. Apoptosis-related protein and gene expression involved in the Nrf2/HO-1 signaling pathway were analyzed using Western blotting and quantitative reverse-transcription polymerase chain reaction (qPCR). Additionally, the active glutathione (GSH) levels in GCs were determined using enzyme-linked immunosorbent assay (ELISA). The number of high-quality embryos and fertilization rates were significantly increased in the EZTG group compared to the control group (both P < 0.05). GCs from the EZTG group showed significant upregulation of GSH and adenosine triphosphate (ATP) levels (both P < 0.05). Western blot and qPCR analyses indicated that the EZTG formula alleviated OS by activating the Nrf2/HO-1 signaling pathway. Specifically, the protein levels of Keap1, Bax, and Caspase-3 were decreased, while those of Nrf2, HO-1, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), and Bcl-2 were increased in the EZTG group compared to the control group (all P < 0.05). Similarly, the mRNA levels of Keap1, Bax, and Caspase-3 were significantly decreased, while Nrf2, HO-1, and Bcl-2 were significantly increased in the EZTG group (all P < 0.05). These findings suggest that the EZTG formula mitigates OS through the Nrf2/HO-1 signaling pathway, ultimately improving embryo quality in IVF-derived embryos. The EZTG formula can improve embryo quality in patients of advanced age by activating the Nrf2/HO-1 signaling pathway, reducing OS and inhibiting GCs apoptosis. This study provides a scientific basis for the application of EZTG formula in improving IVF outcomes for patients of advanced maternal age. www.chictr.org.cn , identifier ChiCTR2200065195. Registered on 31 October 2022.

Despite advances in assisted reproductive technologies, predicting outcomes of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) remains difficult. Hormonal status, oocyte maturity, and ovarian reserve contribute to treatment variability. This study examined correlations among demographic, endocrine, and embryological parameters in women undergoing IVF and ICSI whose partners had normal semen profiles, and evaluated the effect of follicle-stimulating hormone (FSH) levels on outcomes. A retrospective analysis was performed on 488 women aged 18 to 45 years who underwent IVF and ICSI between 2022 and 2024. Data included age, body mass index (BMI), infertility duration, and levels of FSH, luteinizing hormone, anti-Müllerian hormone (AMH), thyroid-stimulating hormone, and fasting blood sugar. Embryological variables were oocyte yield, maturity stages (germinal vesicle, metaphase I, and metaphase II [MII]), and embryo count. Pearson correlations and the Kruskal-Wallis test were used to compare groups stratified by FSH (<10, 10-20, >20 mIU/mL). BMI and infertility duration showed weak correlations with embryological outcomes. AMH correlated positively with embryo count (r=0.29, p<0.01). MII oocytes correlated strongly with oocyte yield (r=0.90, p<0.01) and moderately with embryo count (r=0.46, p<0.01). Women with FSH <10 mIU/mL had significantly higher oocyte yield, MII oocyte numbers, and embryo counts than those with FSH ≥10 mIU/mL (p<0.001). Lower FSH and higher AMH are associated with better oocyte maturity and embryo yield. These markers may support individualized stimulation strategies to improve IVF and ICSI outcomes.

Background: Unexplained infertility (UI) affects a significant portion of couples worldwide, posing challenges for effective treatment. The prognostic nutritional index (PNI), traditionally used in oncology, has been adapted to evaluate reproductive outcomes, particularly in the context of in vitro fertilization (IVF). Method: This study analyzed 198 non-obese couples undergoing IVF for UI at a tertiary care center between February 2023 and December 2024. This study assessed the correlation between the PNI, comprehensive hematological profiles, and IVF outcomes, including embryo quality and pregnancy. The PNI was obtained through serum albumin and lymphocyte counts. Results: The PNI was elevated in the high-quality embryos (51.65 ± 5.09) compared to those of mild-quality (48.10 ± 2.82) and low-quality (44.20 ± 4.16) (p = 0.0001). A higher PNI was associated with improved embryo quality, with an odds ratio of 11.859 (p = 0.0001) for higher quality embryos. Other inflammatory markers did not demonstrate a predictive value for IVF outcomes (p &gt; 0.05). The PNI yielded an area under the curve (AUC) value of 0.895 (95% confidence interval (CI): 0.85–0.94; p = 0.001), indicating robust discrimination. At a cutoff of 46.5, the PNI demonstrated 81.2% sensitivity and 80.1% specificity, further underscoring the potential of this index as a discriminative marker. Conclusions: The PNI serves as a strong indicator of IVF outcomes, correlating directly with embryo quality and the success of fertility treatments. Moreover, the predictive potential of the PNI for embryo quality in reproductive medicine highlights the intersection of nutritional and immunological status with reproductive health, offering a framework for enhancing clinical assessments in IVF.