{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T06:18:25Z","timestamp":1787811505574,"version":"build-2784847793"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Oocyte developmental competence is influenced by the systemic metabolic milieu during folliculogenesis. Inorganic phosphate is essential for ATP synthesis, nucleic acid metabolism, and phosphorylation-dependent signalling, but its relationship with assisted reproductive technology outcomes remains unclear. We investigated whether pre-treatment fasting serum phosphate was associated with live birth after first IVF\/ICSI fresh embryo transfer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 2, 226 women aged 20\u201342 years undergoing their first IVF\/ICSI cycle with fresh embryo transfer between January 2022 and June 2024. Serum phosphate was measured before ovarian stimulation and analysed as quartiles and per 1-SD increase (0.146 mmol\/L). Multivariable logistic regression assessed associations with live birth, adjusting for demographic, ovarian reserve, metabolic, and treatment-related factors. Restricted cubic splines evaluated dose\u2013response relationships. Measurement-window analyses stratified participants by the interval between biochemistry assessment and oocyte retrieval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The overall live birth rate was 60%, increasing from 56% in the lowest phosphate quartile to 66% in the highest (P for trend = 0.003). Each 1-SD increase in serum phosphate was associated with higher odds of live birth (adjusted OR 1.15, 95% CI 1.06\u20131.26; P\u00a0=\u00a00.002), with a linear dose\u2013response (P for non-linearity = 0.305). Serum phosphate was not associated with MII oocyte count or usable embryo count. In measurement-window analyses, the association was consistent in the 60\u2013120 day window (n = 1, 485; adjusted OR 1.18, 95% CI 1.03\u20131.35) and the 120\u2013180 day window (n = 637; adjusted OR 1.16, 95% CI 1.01\u20131.34). The 0\u201360 day stratum was underpowered (n = 104). Additional adjustment for calcium, alkaline phosphatase, fasting glucose, and trigger-day progesterone did not materially alter the results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher pre-treatment serum phosphate was associated with higher odds of live birth after IVF\/ICSI, independent of oocyte yield. External validation and mechanistic studies are required before clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1938890","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:35:25Z","timestamp":1787808925000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre-treatment serum phosphate as a metabolic correlate of live birth after IVF\/ICSI: a retrospective cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Zhilong","family":"Wang","sequence":"first","affiliation":[{"name":"Center for Reproductive Medicine and Obstetrics and Gynecology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University","place":["Nanjing, China"]},{"name":"Center for Molecular Reproductive Medicine, Nanjing University","place":["Nanjing, 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