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Effects of high-altitude hypoxia on embryonic developmental potential in women undergoing IVF/ICSI procedures

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

In this study we examined the effects of long-term adaptation to hypoxia on embryonic developmental potential of oocytes collected from women who underwent IVF/ICSI procedures.

Methods

We selected young infertile women who lived in a low-altitude normoxic environment (n = 80, altitude < 500 m) or high-altitude hypoxic environment (n = 100, altitude > 2500 m) for a lengthy period of time and who planned to undergo IVF/ICSI procedures. We then determined the baseline reproductive hormone levels, gonadotropin (Gn) dose and Gn treatment duration during controlled ovarian hyperstimulation (COH), number of oocytes retrieved, number of mature oocytes, oocyte maturation rate, fertilization rate, normal fertilization rate, day (D3) embryo-formation rate, blastocyst formation rate, good-quality formation rate, D5 blastocyst formation rate, and D6 blastocyst formation rate between the two groups.

Results

Compared with the low-altitude normoxic group, the various reproductive hormone markers of women in the high-altitude hypoxia group were lower, with LH and T levels significantly reduced (P < 0.05) at 72.29 and 72.44% of the normoxic group, respectively (normoxic group vs. hypoxic group, 5.24 ± 1.61 vs. 3.79 ± 1.21; 0.61 ± 0.18 vs. 0.42 ± 0.15; P < 0.05). During ovarian hyperstimulation, a greater Gn dose and longer Gn treatment duration were required for the hypoxic group to complete COH (normoxic group vs. hypoxic group, 2152.08 IU ± 52.76 vs. 2622.09 IU ± 123.28; 9.96 days ± 1.27 vs. 11.54 days ± 1.34, respectively; P < 0.05). The fertilization, cleavage, and D3 embryo-formation rates tended to be higher in the normoxic group than in the hypoxic group (P > 0.05); while the normal fertilization rate tended to lower than in the hypoxic group (P > 0.05). When we conducted an analysis of blastocyst formation rates at different timepoints, we ascertained that the blastocyst formation rate, usable blastocyst rate, and good-quality blastocyst rate of the hypoxic group were all lower than in the normoxic group, with the difference in usable blastocyst rate the most highly significant (normoxic group vs. hypoxic group, 75.31 ± 5.53 vs. 56.04 ± 6.10%, respectively; P < 0.05). In addition, the D5 and D6 blastocyst-formation rates in the normoxic group were slightly higher than in the hypoxic group, revealing that not only were fewer blastocysts formed in the hypoxic group but that there was also a delay in blastocyst formation.

Conclusion

In young women undergoing IVF/ICSI treatment, long-term hypoxic adaptation required augmented Gn dose and Gn treatment duration during COH, and blastocyst developmental potential was also attenuated.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

This work was supported by Qinghai Plateau Famous Medical Talents Project in 2020 and Western Light Project of Chinese Academy of Sciences in 2020.

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Authors and Affiliations

  1. Reproductive Center, Qinghai Provincial People’s Hospital, No. 2, Gonghe Road, Chengdong District, Xining, 810007, Qinghai, China

    Zhengfang Xiong, Bing Ji & Jingrong Jia

  2. Graduate School of Qinghai University, Xining, 810007, China

    Xiaolei Liu & Qingdi Wang

Authors
  1. Zhengfang Xiong
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  2. Xiaolei Liu
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  4. Bing Ji
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Contributions

ZFX and XLL conceived the study and designed the experiments. XLL and QDW performed the study and contributed to data collection. BJ and JRJ performed the data analysis and interpreted the results. ZFX wrote the manuscript. ZFX and XLL contributed to the critical revision of article. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Zhengfang Xiong.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was approved by the Ethics Committee of Qinghai Provincial People's Hospital.

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Informed consent was obtained from all individual participants included in the study.

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Xiong, Z., Liu, X., Wang, Q. et al. Effects of high-altitude hypoxia on embryonic developmental potential in women undergoing IVF/ICSI procedures. Arch Gynecol Obstet 307, 1983–1989 (2023). https://doi.org/10.1007/s00404-023-07014-8

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  • DOI: https://doi.org/10.1007/s00404-023-07014-8

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