1. Impact of oxygen tension according to embryo stage of development: a prospective randomized study
- Author
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Z. Talib, Michael Grynberg, Nathalie Sermondade, C. Herbemont, B. Bennani-Smires, Alexandre Vivot, J Labrosse, M Peigné, E. Vicaut, Christophe Sifer, I. Cédrin-Durnerin, S. Sarandi, Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Histologie - Embryologie - Cytogénétique biologie tumorale et génétique moléculaire [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Hôtel-Dieu [Paris], and Hôpital Lariboisière-Fernand-Widal [APHP]
- Subjects
Adult ,Male ,Pregnancy Rate ,Science ,Cleavage Stage, Ovum ,Fertilization in Vitro ,Group B ,Article ,law.invention ,Andrology ,Embryo Culture Techniques ,03 medical and health sciences ,0302 clinical medicine ,Human fertilization ,Medical research ,Randomized controlled trial ,law ,Pregnancy ,Medicine ,Humans ,Blastocyst ,Prospective Studies ,030304 developmental biology ,0303 health sciences ,030219 obstetrics & reproductive medicine ,Multidisciplinary ,business.industry ,Embryo ,Embryo culture ,Middle Aged ,Embryo Transfer ,Oxygen tension ,Oxygen ,Oxidative Stress ,medicine.anatomical_structure ,Outcomes research ,embryonic structures ,Female ,business ,Embryo quality ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Human embryo culture under 2–8% O2 is recommended by ESHRE revised guidelines for good practices in IVF labs. Nevertheless, notably due to the higher costs of embryo culture under hypoxia, some laboratories perform embryo culture under atmospheric O2 tension (around 20%). Furthermore, recent meta-analyses concluded with low evidence to a superiority of hypoxia on IVF/ICSI outcomes. Interestingly, a study on mice embryos suggested that oxidative stress (OS) might only have an adverse impact on embryos at cleavage stage. Hence, we aimed to demonstrate for the first time in human embryos that OS has a negative impact only at cleavage stage and that sequential culture conditions (5% O2 from Day 0 to Day 2/3, then «conventional» conditions at 20% O2 until blastocyst stage) might be a valuable option for human embryo culture. 773 IVF/ICSI cycles were included in this randomized clinical trial from January 2016 to April 2018. At Day 0 (D0), patients were randomized using a 1:2 allocation ratio between group A (20% O2; n = 265) and group B (5% O2; n = 508). Extended culture (EC) was performed when ≥ 5 Day 2-good-quality-embryos were available (n = 88 in group A (20% O2)). In subgroup B, 195 EC cycles were randomized again at Day 2 (using 1:1 ratio) into groups B’ (5% O2 until Day 6 (n = 101)) or C (switch to 20% O2 from Day 2 to Day 6 (n = 94). Fertilization rate, cleavage-stage quality Day 2-top-quality-embryo (D2-TQE), blastocyst quality (Day 5-top-quality-blastocyst (D5-TQB) and implantation rate (IR) were compared between groups A and B (= cleavage-stage analysis), or A(20% O2), B’(5% O2) and C(5%-to-20% O2). Overall, characteristics were similar between groups A and B. Significantly higher rates of early-cleaved embryos, top-quality and good-quality embryos on Day 2 were obtained in group B compared to group A (P P 2 from Day 0 to Day 6 (group A) resulted in significantly lower Day 5-TQB number and rates (P P = 0.45). At Day 6, TQB numbers and rates were also significantly higher in groups B’ and C compared to group A (P P
- Published
- 2021
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