The elevated levels of serum uric acid (SUA) may be closely associated with female infertility. Serum uric acid to serum creatinine ratio (SUA/SCr) is a standardized indicator for assessing kidney function, providing a more accurate reflection of endogenous SUA levels within the body. Up to now, there have been no reports on the relationship between SUA/SCr and infertility. Therefore, we conducted a study on the relationship between SUA/SCr and infertility.

The analysis was based on data from the 2013–2016 National Health and Nutrition Examination Survey (NHANES), a cross-sectional study of 1918 female participants between the ages of 20 and 45. The levels of SUA (mg/dL) and serum creatinine (mg/dL) were measured, and the reproductive status of each subject was evaluated with reproductive health questionnaire. In the analysis of the whole sample and each group, the Logistic regression model was used to evaluate the relationship between SUA/SCr and infertility. The level of SUA/SCr was analyzed by stratified multivariate Logistic regression model.

Infertility was found in 277 (14.4 %) of the 1,918 female adults in this study, with greater mean SUA/SCr (6.79 ± 1.85 vs. 6.99 ± 1.90). SUA/SCr were associated with infertility in both the initial and adjusted models. According to multivariate logistic regression, the odds of female infertility were found to be significantly higher with rising SUA levels (Q4 [SUA/SCr ≥ 7.78] vs. Q1 [SUA/SCr ≤ 5.37]), fully adjusted odds ratio [OR] = 1.80 p = 0.004]. The data suggests that there is a dose–response relationship between the two.

The results from this nationally representative sample from the United States indicates that the increase of SUA/SCr promotes the occurrence of female infertility events. Infertile women may benefit from improving their lifestyle and modifying dietary habits to reduce the SUA/SCr, which could potentially be advantageous for increasing the probability of pregnancy.