Low-oxygen compared with high-oxygen atmosphere in blastocyst culture, a prospective randomized study

Waldenström, Ulla; Engström, Ann-Britt; Hellberg, Dan; Nilsson, Staffan

doi:10.1016/j.fertnstert.2008.03.051

Cited by 130 publications

(89 citation statements)

References 34 publications

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“…It emerged that the fertilization and cleavage rates in our series were not influenced by the changes in oxygen concentration. This coincides with the findings of other studies [1,4,7,15,17,27]. However, the number of blastomeres on day 3 was significantly higher in the current study when the 5 % O 2 concentration was used compared with the 20 % concentration.…”

Section: Discussionsupporting

confidence: 93%

“…However, studies published between 2000 and 2005 showed conflicting results about the contribution of low oxygen concentrations. Several additional studies in humans have been published since then [1,5,17,27]. All of them were prospective, but the randomization methods they used for examining the differences between the two oxygen concentrations from fertilization to ongoing pregnancies and live births are problematic.…”

Section: Discussionmentioning

confidence: 99%

“…All of them were prospective, but the randomization methods they used for examining the differences between the two oxygen concentrations from fertilization to ongoing pregnancies and live births are problematic. Randomization was either based on day of admission to the IVF laboratory [1], age of the woman, infertility factor, amount of gonadotrophins, number of retrieved oocytes [17], or per patient [15,19,27]. They all saw higher implantation, pregnancy and birth rates with reduced O 2 concentrations.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, a Cochrane review [3], based on three studies that are cited in the current study [16,19,27], found evidence of a beneficial effect of culturing in low oxygen concentrations for the live birth rate (OR 1.39; 95 % CI 1.11 to 1.76; P=0.005; I2=0 %); this would mean that a typical clinic could improve a 30 % live birth rate using atmospheric oxygen concentration to somewhere between 32 % and 43 % by using a low oxygen concentration.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, significantly more surplus embryos reached the blastocyst stage when cultured under 5 % O 2 compared to 20 % O 2 concentration and had more cells when fixed on day 5 as well as on day 6 [6]. A better blastocyst outcome and a significant improvement in pregnancy and birth rates were found with low oxygen concentrations by Waldenström et al [27], but their study was not conducted on sibling oocytes. Kea et al [15] found that different oxygen concentrations did not significantly Capsule Implantation, pregnancy and live birth rate are higher, and more good quality embryos are available for transfer and freezing with reduced rather than with atmospheric oxygen concentrations during embryo incubation.…”

Section: Introductionmentioning

confidence: 94%

See 4 more Smart Citations

The effect of two distinct levels of oxygen concentration on embryo development in a sibling oocyte study

Kasterstein

Strassburger

Komarovsky

et al. 2013

J Assist Reprod Genet

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Purpose This prospective randomized study used sibling oocytes of 258 women with ≥8 oocytes to compare the effect of 5 % O 2 versus 20 % O 2 concentrations on embryo development and clinical outcome. Methods Oocytes of each case were divided between incubators with either 5 % or 20 % O 2 concentration. Outcome measures were fertilization, cleavage, embryo quality, blastocyst formation, and implantation, pregnancy and live birth rates. Results Fertilization and cleavage rates were similar in both groups. The 5 % O 2 group had significantly more blastomeres (P<0.05) and more top-quality embryos on day 3 (P<0.02), as well as significantly more available embryos for transfer (31.6 % vs. 23.1 % for the 20 % O 2 group; P<0.0001). There were significantly more cycles with good embryos in the 5 % group (76/258) than in the 20 % group (38/258) (P<0.0001). Implantation and pregnancy rates were significantly higher for 5 % O 2 embryos (P<0.03 and P<0.05, respectively). Live birth rates per embryo transfer were 34.2 % and 15.8 %, respectively, P<0.05. Conclusions Implantation, pregnancy and live birth rates are higher, and more good quality embryos are available for transfer and freezing with reduced rather than with atmospheric oxygen concentrations during embryo incubation.

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