A controlled randomized trial evaluating the effect of lowered incubator oxygen tension on live births in a predominantly blastocyst transfer program
Authors: Meintjes, Marius; Chantilis, Samuel J.; Douglas, James D.; Rodriguez, Alfred J.; Guerami, Ali R.; Bookout, David M.; Barnett, Brian D.; Madden, James D.
Source: Human Reproduction, Volume 24, Number 2, 16 February 2009 , pp. 300-307(8)
Publisher: Oxford University Press
Abstract:BACKGROUNDThe potentially damaging effect of free O2 radicals to cultured embryos may be reduced by adding scavengers to the culture media or by reducing the incubator O2 levels. However, lowering the O2 in the culture environment can be expensive, troublesome and may not be justifiable. The objective of this study was to evaluate the effect of lowered incubator O2 tension on live birth rates in a predominately Day 5 embryo transfer program.METHODSTwo hundred and thirty first-cycle women undergoing routine IVF or ICSI with ejaculated sperm were randomized in a prospective clinical trial and stratified for patient age and physician. Embryos of patients were randomly assigned for culture in either a 21 O2 (atmospheric) or 5 O2 (reduced) environment. Clinical endpoints monitored were rates of implantation, clinical pregnancy, live birth and blastocyst cryopreservation.RESULTSEmbryos cultured in a 5 O2 environment consistently resulted in higher rates of live birth implantation (106/247, 42.9 versus 82/267, 30.7; difference of 12.2 with 95 confidence interval (CI) of 3.920.3, P 0.005) and live births (66/115, 57.4 versus 49/115, 42.6; difference of 14.8 with 95 CI of 1.927.0, P 0.043) when compared with rates among women whose embryos were cultured in an atmospheric O2 environment.CONCLUSIONSThe overall increase in live births demonstrated by this study indicates that the effort and expense to culture embryos in a low-O2 environment is justified. The study was registered at clinicaltrials.gov. NCT00708487.
Document Type: Research article
Publication date: 2009-02-16
- Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.