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Oxygen concentration from days 1 to 3 after insemination affects the embryo culture quality, cumulative live birth rate, and perinatal outcomes

  • Assisted Reproduction Technologies
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Abstract

Purpose

We aimed to compare embryo development, cumulative live birth rate (CLBR), and perinatal outcomes of embryos cultured in 20% and 5% oxygen from days 1 to 3 after insemination.

Methods

This retrospective study included patients who received in vitro fertilization (IVF) treatment between January 2015 and November 2019. Embryos of each patient were cultured at 20% or 5% oxygen from days 1–3 after insemination. The primary outcome was CLBR. Propensity score matching (PSM) was used to balance patients’ baseline data in both oxygen groups.

Results

In total, 31,566 patients were enrolled. After PSM, the rate of high-quality day 3 embryos was significantly lower in the 20% than in the 5% oxygen group (0.49 ± 0.33 vs 0.51 ± 0.33; adjusted β = −0.03; 95% confidence interval [CI], −0.03 to −0.02). The CLBR was significantly lower in the 20% than in the 5% oxygen group (58.6% vs. 62.4%; adjusted odds ratio = 0.85; 95% CI, 0.81–0.90). The birthweight and Z score of singletons were significantly higher in the 20% than in the 5% oxygen group (birthweight: 3.30 ± 0.50 vs. 3.28 ± 0.48; adjusted β = 0.022; 95% CI, 0.004–0.040; Z score: 0.26 ± 1.04 vs. 0.22 ± 1.01; adjusted β = 0.037; 95% CI, 0.001–0.074).

Conclusion

Culturing embryos at atmospheric oxygen concentrations from days 1 to 3 compromises embryo quality, reduces CLBR, and affects birthweight. The 5% oxygen concentration is more suitable for embryo culture in IVF laboratories to achieve successful outcomes.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

We are grateful to all staff members of the IVF group at the Reproductive and Genetic Hospital of CITIC-Xiangya.

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Author notes

  1. Longbin Chen and Shujuan Ma have contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Institute of Reproductive and Stem Cells, School of Basic Medicine, Central South University, Changsha, China

    Longbin Chen, Fei Gong & Ge Lin

  2. Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China

    Shujuan Ma, Menghan Xie, Fei Gong, Changfu Lu, Shuoping Zhang & Ge Lin

  3. Key Laboratory of Reproductive and Stem Cell Engineering, Ministry of Health, Changsha, China

    Fei Gong & Ge Lin

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  1. Longbin Chen
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Contributions

LC and SM were in charge of the conception, design, and drafting of the article. MX, FG, and CL contributed to data acquisition. SZ and GL were in charge of advice on the experimental design and revising the results. All authors contributed to the article and approved the submitted version.

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Correspondence to Shuoping Zhang or Ge Lin.

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ESM 1

Table S1. Clinical and perinatal outcomes of the first transfer cycle between 20% and 5% oxygen groups. (XLSX 12 kb)

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Chen, L., Ma, S., Xie, M. et al. Oxygen concentration from days 1 to 3 after insemination affects the embryo culture quality, cumulative live birth rate, and perinatal outcomes. J Assist Reprod Genet 40, 2609–2618 (2023). https://doi.org/10.1007/s10815-023-02943-4

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