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Cited by 5Reproductive Health and TechnologiesOvarian function and disordersObesity, Physical Activity, Diet

The nonlinear association between body roundness index and infertility in married women

Open access
Fang, Yong, Ren, Danfeng, Pan, Jinliang, Xu, Qiuyuan·2025·Scientific Reports
DOI 10.1038/s41598-025-86948-2PMC PMC11742883
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Abstract

Infertility is increasingly linked to obesity, especially visceral fat accumulation. The Body Roundness Index (BRI) provides a precise quantification of body and visceral fat but its implications for infertility risks and diagnostic value are yet to be fully determined. This study analyzed data from 1,305 married women aged 20-45 years, drawn from the National Health and Nutrition Examination Survey (NHANES). Logistic regression was utilized to examine the relationship between BRI and infertility, incorporating univariate and multivariate regression analyses, smooth curve fittings, and subgroup analyses. Additionally, Receiver Operating Characteristic (ROC) analysis assessed the predictive capability of BRI for infertility. An increase in one unit of BRI correlated with a 13% higher prevalence of infertility after adjusting for covariates (OR = 1.13; 95% CI: 1.05, 1.21). Women with higher BRI exhibited greater infertility odds compared to the reference group (OR: 2.20, 95% CI: 1.42, 3.42). Smooth curve fitting analysis revealed a positive, nonlinear relationship, with an inflection point observed at a BRI value of 7.95. Subgroup analyses upheld the robustness of this association across varied demographic segments. ROC curves indicated significant diagnostic potential of BRI in younger women, whereas its predictive relevance diminished in those over 35, akin to other obesity markers. This study is the first to rigorously affirm a strong link between increased BRI and the higher prevalence of infertility among married women aged 20-45. To optimize fertility, maintaining a healthy weight and waist circumference is recommended. The integration of BRI into clinical practice could assist in early intervention for women at risk of infertility. However, further research is required to identify effective predictive markers for infertility in women aged 36-45.

AI snapshot

Written from the paper’s full text.

TL;DR

In 1,305 married U.S. women aged 20–45 from NHANES 2013–2018, higher Body Roundness Index (BRI) was associated with greater infertility prevalence in a positive nonlinear relationship. BRI showed diagnostic potential in women ≤35 but not in those >35.

Key findings

  • In the fully adjusted model, each 1-unit increase in BRI was associated with a 13% higher prevalence of infertility (OR = 1.13; 95% CI: 1.05, 1.21; p = 0.0009); the highest BRI tertile had OR = 2.20 (95% CI: 1.42, 3.42; p = 0.0004) versus the lowest tertile.
  • The association was nonlinear, with an inflection point at BRI = 7.95: below 7.95, OR = 1.23 (95% CI: 1.10, 1.36; p = 0.0002); above 7.95, OR = 0.93 (95% CI: 0.76, 1.14; p = 0.4895); likelihood ratio p = 0.038.
  • Subgroup analyses showed no significant interactions (all p for interaction > 0.05).
  • ROC analysis found BRI had the highest AUC among BRI, BMI, WWI, and VAI in women aged ≤35 (AUC = 0.6546; 95% CI: 0.5882, 0.7210), while diagnostic utility was limited in women >35 (BRI AUC = 0.5347; 95% CI: 0.4782, 0.5912).

Methods

  • Cross-sectional secondary analysis of NHANES 2013–2018; final sample of 1,305 married women aged 20–45 after exclusions. Infertility was self-reported via Reproductive Health Questionnaire item RHQ074 (attempted conception for over a year).
  • BRI was calculated from waist circumference and height and compared with BMI, WWI, and VAI. Analyses included univariate and multivariable logistic regression across four models, generalized additive models with smooth curve fitting, two-piecewise linear regression, subgroup analyses, and ROC/AUC analysis.
  • Covariates included age, race/ethnicity, poverty-to-income ratio, education, diabetes, hyperlipidemia, hypertension, smoking, alcohol consumption, physical activity, menstrual regularity, history of pelvic infection treatment, and hormone use; sample weights were applied.

Limitations

  • Stated: self-reported infertility may introduce recall bias; U.S.-only data may limit generalizability; the cross-sectional design precludes definitive causal inference.
  • Stated: restricting to married women reduced the per-cycle sample size, which the authors addressed by pooling three NHANES cycles (2013–2018).
  • Evident: despite covariate adjustment, the observational design leaves potential residual or unmeasured confounding; the paper also notes poor diagnostic performance of obesity indices in women aged 36–45.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1038/s41598-025-86948-2

Cites

41 of 41 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

18 of 26 cited sources checked · 7 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Inflammatory cytokines released by visceral fat may negatively impact fertility by impairing endometrial receptivity.

    “Moreover, the inflammatory cytokines released by visceral fat may negatively impact fertility by impairing the endometrial receptivity necessary for successful implantation20,38.”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [20] Wang, W., Hou, S., Wang, K., Ling, B. & Yu, H. Association of body roundness index with female infertility: 2013–2018 NHANES. Front. Nutr. 11, 1416637. https://doi.org/10.3389/fnut.2024.1416637 (2024). source
    • cites [38] Vannuccini, S. et al. Infertility and reproductive disorders: impact of hormonal and inflammatory mechanisms on pregnancy outcome. Hum. Reprod. Update. 22, 104–115. https://doi.org/10.1093/humupd/dmv044 (2016). source

      The Endometrium section says inflammatory processes in women with endometriosis can reduce endometrial receptivity and affect pregnancy outcomes. It also discusses fat-tissue hormones in obesity and PCOS, but does not identify inflammatory cytokines released by visceral fat as the cause of impaired receptivity. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
  • Premisecitation

    The Body Roundness Index (BRI) offers a superior estimation of body fat distribution and visceral adiposity than other traditional anthropometric measures.

    “Introduced in 2013, the Body Roundness Index (BRI) offers a superior estimation of body fat distribution and visceral adiposity than other traditional anthropometric measures15,16.”
    • Also stated in: § Discussion · plain
      “The BRI, by providing a more accurate estimation of visceral fat, offers significant insights into the role of abdominal obesity in reproductive challenges15.”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [15] Thomas, D. M. et al. Relationships between body roundness with body fat and visceral adipose tissue emerging from a new geometrical model. Obesity 21, 2264–2271. https://doi.org/10.1002/oby.20408 (2013). source
    • cites [16] Zhang, X. et al. Body roundness index and all-cause mortality among US adults. JAMA Netw. Open. 7, e2415051. https://doi.org/10.1001/jamanetworkopen.2024.15051 (2024). source
  • Premisecitation

    BMI is limited in its ability to differentiate between lean and fat tissues.

    “While BMI is a common measure of obesity, it is limited in its ability to differentiate between lean and fat tissues10,11.”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [10] Cai, S. et al. Association of the weight-adjusted-waist index with risk of all-cause mortality: A 10-year follow-up study. Front. Nutr. 9, 894686. https://doi.org/10.3389/fnut.2022.894686 (2022). source

      The Introduction calls BMI a widely used measure of obesity and says it cannot distinguish visceral fat from fat in other areas. That supports the general point that BMI has limitations, but it does not state the specific claimed limitation: distinguishing lean tissue from fat tissue. The Discussion addresses fat and muscle mass in relation to WWI, not BMI. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
    • cites [11] Park, Y., Kim, N. H., Kwon, T. Y. & Kim, S. G. A novel adiposity index as an integrated predictor of cardiometabolic disease morbidity and mortality. Sci. Rep. 8, 16753. https://doi.org/10.1038/s41598-018-35073-4 (2018). source
  • Premisecitation

    BRI enhances the ability to identify abdominal obesity, particularly in individuals with excess visceral fat, providing a more accurate assessment of this condition.

    “This feature enhances the BRI’s ability to identify abdominal obesity, particularly in individuals with excess visceral fat, providing a more accurate assessment of this condition18.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [18] Li, M. et al. The pathophysiological associations between obesity, NAFLD, and atherosclerotic cardiovascular diseases. Horm. Metab. Res. 56, 683–696. https://doi.org/10.1055/a-2266-1503 (2024). source

      The Insulin resistance section says visceral fat mass and waist circumference correlate with insulin resistance, but it does not discuss BRI or its accuracy in identifying abdominal obesity. Searches for “BRI,” “body roundness index,” and abdominal-obesity assessment found no passage addressing that claim in our copy. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
  • Findingown data

    In women older than 35, BRI was not significantly associated with infertility (OR = 1.07; 95% CI: 0.97, 1.18; p = 0.1911).

    “| Older than 35 | 1.07 (0.97, 1.18) 0.1911 |”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 16
  • May combine two claims. 13
  • The quote only partly states this claim. 2

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    More precise measures have been developed to assess visceral fat accumulation, which is closely linked to reproductive dysfunction.

    “Recently, more precise measures have been developed to assess visceral fat accumulation, which is closely linked to reproductive dysfunction12.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [12] Deng, C., Ke, X., Lin, L., Fan, Y. & Li, C. Association between indicators of visceral lipid accumulation and infertility: A cross-sectional study based on U.S. women. Lipids Health Dis. 23, 186. https://doi.org/10.1186/s12944-024-02178-x (2024). source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    BRI is less influenced by muscle mass, making it a more reliable indicator of fat-related health risks in individuals with higher muscle mass.

    “Furthermore, the BRI is less influenced by muscle mass, making it a more reliable indicator of fat-related health risks in individuals with higher muscle mass19.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [19] Tian, S., Zhang, X., Xu, Y. & Dong, H. Feasibility of body roundness index for identifying a clustering of cardiometabolic abnormalities compared to BMI, waist circumference and other anthropometric indices: the China health and nutrition survey, 2008 to 2009. Med. (Baltim). 95, e4642. https://doi.org/10.1097/MD.0000000000004642 (2016). source

      The Introduction (page unavailable) says BMI cannot distinguish muscle from fat and that abdominal measures address this limitation. The Discussion (page unavailable) says BRI uses waist and height to estimate body fat and is useful for identifying cardiometabolic abnormalities. The paper does not establish that BRI is less influenced by muscle mass or more reliable specifically in people with higher muscle mass. (LLM, conf=0.79)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Excess fat, particularly in the abdominal region, can elevate estrogen levels in obese women, disrupting hormonal balance and causing irregularities in ovulation and menstrual cycles.

    “Excess fat, particularly in the abdominal region, can elevate estrogen levels in obese women, disrupting hormonal balance and causing irregularities in ovulation and menstrual cycles35,36.”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [35] Jurczewska, J. et al. Abdominal obesity in women with polycystic ovary syndrome and its relationship with diet, physical activity and insulin resistance: A pilot study. Nutrients 15 https://doi.org/10.3390/nu15163652 (2023). source

      The Introduction (page unavailable) says visceral fat is associated with hormonal disturbances in women with PCOS and identifies anovulation as a feature of PCOS. It does not say that abdominal fat raises estrogen levels or that elevated estrogen causes ovulatory or menstrual irregularities; searches for estrogen and the proposed mechanism found no supporting passage. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [36] Incedal Irgat, S. & Bakirhan, H. The effect of obesity on human reproductive health and foetal life. Hum. Fertil. (Camb). 25, 860–871. https://doi.org/10.1080/14647273.2021.1928774 (2022). source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The weight-adjusted waist circumference index (WWI) shows a positive association with infertility among U.S. women.

    “For instance, the weight-adjusted waist circumference index (WWI) shows a positive association with infertility among U.S. women13.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [13] Zhong, H. et al. Associations between weight-adjusted-waist index and infertility: Results from NHANES 2013 to 2020. Medicine 102, e36388. https://doi.org/10.1097/MD.0000000000036388 (2023). source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The Visceral Adiposity Index (VAI) is positively correlated with increased infertility incidence.

    “Similarly, the Visceral Adiposity Index (VAI), which reflects dysfunction and accumulation of visceral adipose tissue, has been positively correlated with increased infertility incidence14.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [14] Zhuang, J., Wang, Y., Wang, S., Hu, R. & Wu, Y. Association between visceral adiposity index and infertility in reproductive-aged women in the United States. Sci. Rep. 14, 14230. https://doi.org/10.1038/s41598-024-64849-0 (2024). source

  • May combine two claims.

    Premisecitation

    BRI incorporates waist circumference, offering a more comprehensive perspective on body shape than BMI.

    “Unlike the BMI, which is based solely on height and weight, the BRI incorporates waist circumference, offering a more comprehensive perspective on body shape17.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [17] Zhou, D., Liu, X., Huang, Y. & Feng, Y. A nonlinear association between body roundness index and all-cause mortality and cardiovascular mortality in general population. Publ Health Nutr. 25, 3008–3015. https://doi.org/10.1017/S1368980022001768 (2022). source

      The Methods (Data collection; page unavailable) state that BMI is calculated from weight and height and describe measuring waist circumference, but our copy omits the variables in the printed BRI formula. The Discussion says BMI does not account for fat distribution and that BRI reflects abdominal obesity or body shape, supporting the broader comparison. The copy does not explicitly establish that waist circumference is an input to BRI. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The inclusion of height in the BRI formula distinguishes it from other obesity indices such as WWI or VAI, allowing it to more thoroughly reflect body composition and fat distribution.

    “Additionally, the inclusion of height in the BRI formula distinguishes it from other obesity indices such as WWI or VAI, allowing it to more thoroughly reflect an individual’s body composition and fat distribution14,20,21.”
    Quote in the paperNot a substantial claim3 of 3 sources checked
    • cites [14] Zhuang, J., Wang, Y., Wang, S., Hu, R. & Wu, Y. Association between visceral adiposity index and infertility in reproductive-aged women in the United States. Sci. Rep. 14, 14230. https://doi.org/10.1038/s41598-024-64849-0 (2024). source

      The Calculation of VAI section gives a VAI formula with no separate height term, providing limited support for the comparison. The paper does not discuss BRI or WWI, establish that BRI includes height, or show that BRI reflects body composition and fat distribution more thoroughly than VAI. Page numbers are unavailable in our copy. (LLM, conf=0.72)

      Experimental — accuracy not yet measured
    • cites [20] Wang, W., Hou, S., Wang, K., Ling, B. & Yu, H. Association of body roundness index with female infertility: 2013–2018 NHANES. Front. Nutr. 11, 1416637. https://doi.org/10.3389/fnut.2024.1416637 (2024). source

      The Methods (BRI measurement; page unavailable) give a formula that includes height, and the Discussion (page unavailable) says incorporating height helps BRI reflect body shape and fat distribution more comprehensively than waist circumference alone. The paper does not make the claimed comparison with WWI or VAI, so it does not establish that height distinguishes BRI from those indices. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
    • cites [21] Sun, F. et al. Associations of weight-adjusted-waist index and depression with secondary infertility. Front. Endocrinol. 15, 1330206. https://doi.org/10.3389/fendo.2024.1330206 (2024). source

      The Materials and methods section (Assessment of other obesity indicators; page unavailable) gives a BRI formula containing height and a WWI formula without it. It does not give a VAI formula or establish that including height lets BRI reflect body composition and fat distribution more thoroughly. The Results instead find WWI more predictive than BRI for secondary infertility, which does not resolve their relative ability to reflect body composition. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    BRI is well-documented as a robust predictor of diabetes, including prediabetes, cardiometabolic disorders, and metabolic syndrome.

    “The BRI is well-documented as a robust predictor of diabetes, including prediabetes, cardiometabolic disorders, and metabolic syndrome32–34.”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites [32] Wang, J., Wu, M., Wu, S. & Tian, Y. Relationship between body roundness index and the risk of heart failure in Chinese adults: The Kailuan cohort study. ESC Heart Fail. 9, 1328–1337. https://doi.org/10.1002/ehf2.13820 (2022). source

      The Introduction (page unavailable) says prior studies identified BRI as a risk factor for diabetes mellitus, coronary artery disease, and carotid atherosclerosis. It does not address prediabetes or metabolic syndrome, or establish that BRI is a robust predictor of those conditions. This study's own results concern heart failure. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [33] Li, Y. et al. Body roundness index and waist-hip ratio result in better cardiovascular disease risk stratification: Results from a large Chinese cross-sectional study. Front. Nutr. 9, 801582. https://doi.org/10.3389/fnut.2022.801582 (2022). source

      The Introduction (page unavailable) calls BRI a good predictor of metabolic syndrome, and the Results report that BRI discriminated diabetes and several cardiovascular risk factors in the studied Chinese population. The paper does not report prediabetes as an outcome. Its cross-sectional findings concern identification of existing conditions, rather than prediction of future diabetes, so the claim is broader than this source supports. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
    • cites [34] Zhao, Q. et al. Capacity of a body shape index and body roundness index to identify diabetes mellitus in Han Chinese people in Northeast China: A cross-sectional study. Diabet. Med. 35, 1580–1587. https://doi.org/10.1111/dme.13787 (2018). source

  • May combine two claims.

    Findingown data

    Subgroup analyses showed no significant interactions (all p for interaction > 0.05), indicating that age, race, alcohol consumption, smoking status, diabetes, hyperlipidemia, menstrual regularity, and hormone use did not significantly modify the BRI-infertility relationship.

    “No significant interactions were observed (all p for interaction > 0.05), indicating that these factors did not significantly modify the observed relationship.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In participants aged ≤35, the AUC for BRI was 0.6546 (95% CI: 0.5882, 0.7210), for BMI 0.6412 (0.5749, 0.7076), for WWI 0.6449 (0.5845, 0.7052), and for VAI 0.5808 (0.5186, 0.6430).

    “In the subgroup of participants aged ≤ 35 years, the AUC values for BRI, BMI, WWI, and VAI were 0.6546 (95% CI: 0.5882,0.7210), 0.6412 (95% CI: 0.5749,0.7076), 0.6449 (95% CI: 0.5845,0.7052), and 0.5808 (95% CI: 0.5186,0.6430), respectively.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The likelihood ratio test comparing piecewise models to standard linear models revealed a significant improvement (p = 0.038), suggesting the piecewise model more accurately represented the data.

    “The likelihood ratio tests comparing the piecewise models to standard linear models revealed a significant improvement (p = 0.038), suggesting that the piecewise model more accurately represented the data.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    The highest tertile of BRI was associated with a 120% increased prevalence of infertility compared to the lowest tertile in Model 4 (OR = 2.20; 95% CI: 1.42, 3.42).

    “Furthermore, the highest tertile of BRI was associated with an 120% increased prevalence of infertility compared to the lowest tertile in Model 4, underscoring a significant trend (p for trend = 0.0004).”
    • Also stated in: § Abstract · plain
      “Women with higher BRI exhibited greater infertility odds compared to the reference group (OR: 2.20, 95% CI: 1.42, 3.42).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In participants older than 35, the AUC values for BRI, BMI, WWI, and VAI were 0.5347 (0.4782, 0.5912), 0.5542 (0.4974, 0.6111), 0.5157 (0.4583, 0.5731), and 0.5309 (0.4748, 0.5870), respectively.

    “Conversely, in participants older than 35 years, the diagnostic utility of these indices was limited, with AUC values for BRI, BMI, WWI, and VAI were 0.5347 (95% CI: 0.4782, 0.5912), 0.5542 (95% CI: 0.4974, 0.6111), 0.5157 (95% CI: 0.4583, 0.5731), and 0.5309 (95% CI: 0.4748, 0.5870), respectively (Table 6).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In fully adjusted Model 4, BRI was positively associated with infertility (OR = 1.13; 95% CI: 1.05, 1.21; p = 0.0009), indicating a 13% increase in prevalence per unit increase in BRI.

    “The fully adjusted Model 4 confirmed a significant positive association (OR = 1.13; 95% CI: 1.05, 1.21; p = 0.0009), indicating a 13% increase in the prevalence of infertility per unit increase in BRI.”
    • Also stated in: § Abstract · plain
      “An increase in one unit of BRI correlated with a 13% higher prevalence of infertility after adjusting for covariates (OR = 1.13; 95% CI: 1.05, 1.21).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Obesity negatively affects reproductive health, with obese women often experiencing irregular menstruation, impaired ovulation, and endometriosis.

    “The negative effects of obesity on reproductive health are well-documented, as obese women often experience irregular menstruation, impaired ovulation, and endometriosis9.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [9] Ennab, F. & Atiomo, W. Obesity and female infertility. Best Pract. Res. Clin. Obstet. Gynaecol. 89, 102336. https://doi.org/10.1016/j.bpobgyn.2023.102336 (2023). source

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The incorporation of appropriate sample weights ensures reliability and broader applicability of results.

    “Furthermore, the incorporation of appropriate sample weights ensures not only the reliability but also the broader applicability of our results.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Sample weights were applied in statistical estimates to accurately represent the noninstitutionalized civilian U.S. population.

    “In adherence to guidelines set by the NCHS, we applied sample weights in our statistical estimates to accurately represent the noninstitutionalized civilian U.S. population.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductreasoning

    Excluding divorced, separated, or unmarried individuals minimized potential biases and improved the reliability of findings.

    “By excluding divorced, separated, or unmarried individuals from our analysis, we minimized potential biases, thereby improving the reliability of our findings.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Focusing on married women enhances the accuracy of infertility responses.

  • May combine two claims.

    Premisecitation

    Abdominal obesity is often associated with conditions such as polycystic ovary syndrome (PCOS), which exacerbates ovulatory dysfunction and hormonal imbalances.

    “Additionally, abdominal obesity is often associated with conditions such as polycystic ovary syndrome (PCOS), which exacerbates ovulatory dysfunction and hormonal imbalances37.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37] Tatarchuk, T. et al. The effect of gastric sleeve resection on menstrual pattern and ovulation in premenopausal women with classes III–IV obesity. Obes. Surg. 32, 599–606. https://doi.org/10.1007/s11695-021-05820-0 (2022). source

  • The quote only partly states this claim.

    Interpretationown data

    The diagnostic utility of BRI, BMI, WWI, and VAI for infertility is limited in women older than 35.

    “However, the efficacy of these indices in women aged 36 to 45 remains uncertain, underscoring an urgent need for targeted research to develop more effective diagnostic tools for this age group.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    MRI and CT are universally recognized as the gold standards for assessing visceral fat.

    “Magnetic resonance imaging (MRI) and computed tomography (CT) are universally recognized as the gold standards for assessing visceral fat.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [39] Cornier, M. A. et al. Assessing adiposity: A scientific statement from the American heart association. Circulation 124, 1996–2019. https://doi.org/10.1161/CIR.0b013e318233bc6a (2011). source

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    Infertility is defined as the inability to conceive after 12 months of regular, unprotected sexual intercourse.

    “Infertility is medically defined as the inability to conceive after 12 months of regular, unprotected sexual intercourse1.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [1] Broughton, D. E. & Moley, K. H. Obesity and female infertility: Potential mediators of obesity’s impact. Fertil. Steril. 107, 840–847. https://doi.org/10.1016/j.fertnstert.2017.01.017 (2017). source

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Anthropometric measurements were collected by trained examiners at a mobile examination center equipped with standardized instruments.

    “Anthropometric measurements, including body height, body weight, and waist circumference (WC), were collected by trained examiners at a mobile examination center equipped with standardized instruments.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study's reliance on self-reported infertility via questionnaires could introduce bias due to potential recall inaccuracies.

    “However, the study’s reliance on self-reported infertility via questionnaires could introduce bias due to potential recall inaccuracies.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationown data

    The study effectively bridges a critical gap in the current literature by linking specific body composition metrics with reproductive health outcomes.

    “It effectively bridges a critical gap in the current literature by linking specific body composition metrics with reproductive health outcomes.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationnone given

    The conclusions are primarily relevant to the cohort of U.S. women studied.

    “However, it is vital to note that these conclusions are primarily relevant to the cohort of U.S. women studied.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    ROC curves indicated significant diagnostic potential of BRI in younger women, whereas its predictive relevance diminished in those over 35, akin to other obesity markers.

    “ROC curves indicated significant diagnostic potential of BRI in younger women, whereas its predictive relevance diminished in those over 35, akin to other obesity markers.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Focusing on married women resulted in a smaller sample size for each cycle.

    “However, we acknowledge that this approach resulted in a smaller sample size for each cycle.”
    Quote in the paperNot a substantial claim
28 of 28

  • The paper relies on this without support.

    The significance of BRI in relation to infertility among married women has not been explored.

    “Despite its promising advantages, the significance of the BRI in relation to infertility among married women has yet to be explored.”

  • The paper relies on this without support.

    Focusing on married women enhances the accuracy of infertility responses.

    “with a strategic focus on married women to enhance the accuracy of responses regarding infertility issues.”
2 of 2

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Model 4 lists marital status as a covariate despite restricting the sample to married women

    Minor

    The sample excluded everyone whose marital status was other than married, so marital status cannot vary among the analyzed participants. The Table 2 note nevertheless lists it as a Model 4 adjustment variable; the Methods description of Model 4 omits it.

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Authors
Fang, Y., Ren, D., Pan, J., & Xu, Q.
Affiliations
The First People's Hospital of Xiaoshan District, Hangzhou (CN)
ORCID
Fang, Yong
Venue
Scientific Reports
Publisher
Springer Science and Business Media LLC
Published
2025-01-18
Volume
15
Issue
1
Pages
2431-2431
ISSN
2045-2322 (ISSN-L)
DOI
10.1038/s41598-025-86948-2
PMC
PMC11742883
OpenAlex
W4406565254
Semantic Scholar
a9110d0ab67e43352b17be2fc12712c8866998c1
Cited by
5
References
41
Citations by year
2026: 2 · 2025: 3
FWCI
3.36
Type
journal article
Language
en
Open access
Licence
Locations
  • Scientific Reports (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion, cc-by-nc-nd)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
body roundness index, female infertility, obesity, visceral fat, fat mass, married women, nonlinear relationship, inflection point, infertility prediction, reproductive age, waist circumference
MeSH terms
Adult, Female, Humans, Infertility, Female, Marriage, Middle Aged, Nutrition Surveys, Obesity, ROC Curve, Body Mass Index, Prevalence, Intra-Abdominal Fat, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-20.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-20.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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