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Influence of human embryo cultivation in a classic CO2 incubator with 20% oxygen versus benchtop incubator with 5% oxygen on live births: the randomized prospective trial

Published online by Cambridge University Press:  10 May 2019

Nina Gelo*
Affiliation:
University Hospital Centre Zagreb, Department of Obstetrics and Gynecology, Petrova 13, 10 000 Zagreb, Croatia
Gabriela Kirinec
Affiliation:
University Hospital Centre Zagreb, Department of Obstetrics and Gynecology, Petrova 13, 10 000 Zagreb, Croatia
Dinka Pavičić Baldani
Affiliation:
University Hospital Centre Zagreb, Department of Obstetrics and Gynecology, Petrova 13, 10 000 Zagreb, Croatia The University of Zagreb, School of Medicine, Šalata 3, 10 000 Zagreb, Croatia
Hrvoje Vrčić
Affiliation:
University Hospital Centre Zagreb, Department of Obstetrics and Gynecology, Petrova 13, 10 000 Zagreb, Croatia The University of Zagreb, School of Medicine, Šalata 3, 10 000 Zagreb, Croatia
Davor Ježek
Affiliation:
University Hospital Centre Zagreb, Department of Obstetrics and Gynecology, Petrova 13, 10 000 Zagreb, Croatia The University of Zagreb, School of Medicine, Šalata 3, 10 000 Zagreb, Croatia
Milan Milošević
Affiliation:
The University of Zagreb, School of Medicine, Šalata 3, 10 000 Zagreb, Croatia Andrija Štampar, School of Public Health, Rockefellerova 4, 10 000 Zagreb, Croatia
Patrik Stanić
Affiliation:
Polyclinic Repromed, Gradiščanska 36, 10 000 Zagreb, Croatia
*
*Address for correspondence: Nina Gelo. University Hospital Centre Zagreb, Department of Obstetrics and Gynecology, Petrova 13, 10 000 Zagreb, Croatia. Tel: +385 91 252 1235. Fax: +385 1 23 7 62 67. E-mail address: ngelo@kbc-zagreb.hr

Summary

Our objective was to assess the effect of benchtop incubators with low oxygen concentrations on the clinical and embryological parameters of our patients. We conducted a prospective, randomized, opened controlled trial on infertile patients in stimulated cycles. In total, 738 infertile patients were assessed for eligibility and, after final exclusions, 230 patients were allocated either to a 5% O2 group (benchtop incubator) or a 20% O2 group (classic incubator). Finally, 198 patients in the 5% O2 group and 195 in the 20% O2 group were analysed. The outcomes measured were fertilization rate, clinical pregnancy rate, and live birth rate. The primary outcome – live birth rate per all transfers – did not show any improvement in the 5% oxygen group over the 20% oxygen group (25.3% versus 22.6%, P=0.531), but the number of day 5 blastocysts was significantly higher (P=0.009). Fertilization rate did not show any beneficial effect of reduced oxygen (5%) (73.4%±22.4% versus 74.6%±24.0%, P=0.606) per all transfers but there was statistically significant difference in the day 5 SET subgroup (85.3±15.1 versus 75.1±17.5; P=0.004). Clinical pregnancy rate showed results in favour of the 5% oxygen group for all subgroups (day 3: 23.7% versus 21.1%, P=0.701; day 5 SET: 35.0% versus 30.6%. P=0.569) but showed statistical significance only in the day 5 SET subgroup (51.1% versus 29.8%; P=0.038). Culturing of embryos in benchtop incubators under low oxygen produced more blastocysts and therefore was a better alternative for embryo selection, which resulted in higher pregnancy rates. To achieve higher live birth rates, embryo quality is not the only factor.

Type
Research Article
Copyright
© Cambridge University Press 2019 

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Influence of human embryo cultivation in a classic CO2 incubator with 20% oxygen versus benchtop incubator with 5% oxygen on live births: the randomized prospective trial
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