Association between relative fat mass and female infertility among reproductive-aged women from NHANES 2013–2020

Abstract Female infertility is a prevalent condition closely linked with obesity. Current evaluation metrics like body mass index (BMI) and waist circumference (WC) have limitations. Relative fat mass (RFM) is a newer, more accurate obesity metric, but its relationship with infertility lacks researc...

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Main Authors: Yiming Chen, Yuanyuan Li, Bo Zhang, Wei Xia, Xingliang Feng
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-97243-5
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author Yiming Chen
Yuanyuan Li
Bo Zhang
Wei Xia
Xingliang Feng
author_facet Yiming Chen
Yuanyuan Li
Bo Zhang
Wei Xia
Xingliang Feng
author_sort Yiming Chen
collection DOAJ
description Abstract Female infertility is a prevalent condition closely linked with obesity. Current evaluation metrics like body mass index (BMI) and waist circumference (WC) have limitations. Relative fat mass (RFM) is a newer, more accurate obesity metric, but its relationship with infertility lacks research. Data from 3489 female participants aged 18–45 years from the NHANES 2013–2020 cycles were extracted and analyzed. Infertility was assessed based on participants’ pregnancy attempts and medical consultations. The primary exposure variables were BMI, WC, and RFM. Survey-weighted logistic regression models were conducted to compare their associations with infertility, expressed as odds ratios (ORs). RFM was further categorized into quartiles for additional regression analysis. Subgroup analyses were conducted to evaluate whether the association between RFM and infertility differs across key demographic and clinical factors, including age, race, PIR, education level, BMI, smoking status, DM, hypertension, age at menarche, and history of pelvic inflammatory disease (PID). Restricted cubic splines (RCS) were employed for robustness and linearity assessments. Our results showed an infertility prevalence of 13.41%, with affected women being older and having higher BMI. The OR (1.039, 95% CI: 1.010, 1.068) for RFM in regression analysis of fully adjusted Model was higher than for BMI (1.020, 95% CI: 1.002, 1.039) and WC (1.014, 95% CI: 1.006, 1.022), indicating that each unit increase in RFM correlates with a higher risk of infertility. Similarly, quartile analysis of fully adjusted Model indicated increased infertility risk with higher RFM quartiles (Q2: OR = 1.66, 95% CI: 1.05, 2.64; Q3: OR = 1.79, 95% CI: 1.16, 2.74; Q4: OR = 2.23, 95% CI: 1.38, 3.60). Additionally, results were consistent in the supplementary subgroup analysis without interaction, and RCS confirmed a linear relationship. Our findings demonstrate a significant association between RFM and female infertility in a population-based sample, supporting the hypothesis that excess adiposity may play a role in reproductive health. Further research is needed to explore the mechanisms and broader applications of RFM in female reproductive health.
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spelling doaj-art-8c2bb9adf4f24bf2afbb6898edc862cc2025-08-20T02:17:57ZengNature PortfolioScientific Reports2045-23222025-04-0115111210.1038/s41598-025-97243-5Association between relative fat mass and female infertility among reproductive-aged women from NHANES 2013–2020Yiming Chen0Yuanyuan Li1Bo Zhang2Wei Xia3Xingliang Feng4Department of Urology, The First People’S Hospital of ChangzhouDepartment of General Surgery, The Third Affiliated Hospital of Soochow UniversityDepartment of Urology, The First People’S Hospital of ChangzhouDepartment of Urology, The First People’S Hospital of ChangzhouDepartment of Urology, The First People’S Hospital of ChangzhouAbstract Female infertility is a prevalent condition closely linked with obesity. Current evaluation metrics like body mass index (BMI) and waist circumference (WC) have limitations. Relative fat mass (RFM) is a newer, more accurate obesity metric, but its relationship with infertility lacks research. Data from 3489 female participants aged 18–45 years from the NHANES 2013–2020 cycles were extracted and analyzed. Infertility was assessed based on participants’ pregnancy attempts and medical consultations. The primary exposure variables were BMI, WC, and RFM. Survey-weighted logistic regression models were conducted to compare their associations with infertility, expressed as odds ratios (ORs). RFM was further categorized into quartiles for additional regression analysis. Subgroup analyses were conducted to evaluate whether the association between RFM and infertility differs across key demographic and clinical factors, including age, race, PIR, education level, BMI, smoking status, DM, hypertension, age at menarche, and history of pelvic inflammatory disease (PID). Restricted cubic splines (RCS) were employed for robustness and linearity assessments. Our results showed an infertility prevalence of 13.41%, with affected women being older and having higher BMI. The OR (1.039, 95% CI: 1.010, 1.068) for RFM in regression analysis of fully adjusted Model was higher than for BMI (1.020, 95% CI: 1.002, 1.039) and WC (1.014, 95% CI: 1.006, 1.022), indicating that each unit increase in RFM correlates with a higher risk of infertility. Similarly, quartile analysis of fully adjusted Model indicated increased infertility risk with higher RFM quartiles (Q2: OR = 1.66, 95% CI: 1.05, 2.64; Q3: OR = 1.79, 95% CI: 1.16, 2.74; Q4: OR = 2.23, 95% CI: 1.38, 3.60). Additionally, results were consistent in the supplementary subgroup analysis without interaction, and RCS confirmed a linear relationship. Our findings demonstrate a significant association between RFM and female infertility in a population-based sample, supporting the hypothesis that excess adiposity may play a role in reproductive health. Further research is needed to explore the mechanisms and broader applications of RFM in female reproductive health.https://doi.org/10.1038/s41598-025-97243-5ObesityFemale infertilityRelative fat massNHANESCross-sectional study
spellingShingle Yiming Chen
Yuanyuan Li
Bo Zhang
Wei Xia
Xingliang Feng
Association between relative fat mass and female infertility among reproductive-aged women from NHANES 2013–2020
Scientific Reports
Obesity
Female infertility
Relative fat mass
NHANES
Cross-sectional study
title Association between relative fat mass and female infertility among reproductive-aged women from NHANES 2013–2020
title_full Association between relative fat mass and female infertility among reproductive-aged women from NHANES 2013–2020
title_fullStr Association between relative fat mass and female infertility among reproductive-aged women from NHANES 2013–2020
title_full_unstemmed Association between relative fat mass and female infertility among reproductive-aged women from NHANES 2013–2020
title_short Association between relative fat mass and female infertility among reproductive-aged women from NHANES 2013–2020
title_sort association between relative fat mass and female infertility among reproductive aged women from nhanes 2013 2020
topic Obesity
Female infertility
Relative fat mass
NHANES
Cross-sectional study
url https://doi.org/10.1038/s41598-025-97243-5
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