Inappropriate range of fasting plasma glucose may affect embryo euploidy negatively: a retrospective cohort study

Accurate assessment of embryo quality is paramount in reproductive medicine, for which determining embryonic euploidy is a critical metric. The impact of diabetes on fertility is well documented; however, the influence of fasting plasma glucose (FPG) levels on embryonic euploidy rates among women without diabetes remains understudied. This retrospective cohort study enrolled 985 women who underwent preimplantation genetic testing for aneuploidies (PGT-A) between December 2017 and December 2023. Participants were grouped into quartiles based on FPG levels. Restricted cubic spline (RCS) and multiple linear regression models were used to assess the correlation between FPG levels and embryonic euploidy rates in women without diabetes. In total, 4,786 embryos were analyzed. Groups with higher FPG levels exhibited significantly reduced embryonic euploidy rates (P < 0.001), 2PN cleavage numbers, metaphase II oocyte counts, high-quality blastocyst counts, and rates of high-quality blastocysts (β < 0). These significant correlations persisted even after adjusting for potential confounders (P = 0.007). Furthermore, RCS analysis indicated an optimal FPG range of 4.57–5.19 mmol/L. This study provided preliminary evidence of an association between FPG level and embryonic euploidy rates in women without diabetes undergoing assisted reproductive technology (ART). The findings indicate the benefits of FPG level assessment and management before undergoing ART. Future studies should investigate the impact of glucose control on ART outcomes and establish optimal glucose management strategies.