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The aim of this retrospective analysis was to explore whether an elevated ALT level before pregnancy is associated with a reduction in live birth rate after IVF-FET. Retrospective observational study. Shiyan People’s Hospital, China between January 2019 and December 2019. Women aged ≤ 40 years. Freeze-thawed embryo transfer (FET) The live birth rate, which was defined as the delivery of a live baby after 24 weeks of gestation. The analysis included 365 FET cycles. There was a significant difference between groups in the live birth rate ( p  &lt; .05), which was highest for the low ALT tertile and lowest for the high ALT tertile. Multiple regression analysis with adjustment for multiple potential confounders revealed that the odds of live birth were decreased for each one standard deviation increase in ALT (OR = 0.56, 95%CI = 0.42–0.75,  p  &lt; .0001) and lower for the high ALT tertile than for the low ALT tertile (OR = 0.38, 95%CI = 0.19–0.75,  p  = .0055). Smooth curve fitting showed an inverse relationship between ALT and live birth rate. Our findings indicate that relatively small elevations in baseline serum ALT level can have a clinically relevant impact on the success of FET.

Higher baseline alanine aminotransferase level is associated with lower live birth rate after freeze-thawed embryo transfer