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Low-oxygen compared with high-oxygen atmosphere in blastocyst culture, a prospective randomized study
In Vitro Fertilization Unit, Falun Hospital, Falun.
In Vitro Fertilization Unit, Falun Hospital, Falun.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Center for Clinical Research Dalarna. (Obstetrisk forskning/Axelsson)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Center for Clinical Research Dalarna. (Obstetrisk forskning/Axelsson)
2009 (English)In: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 91, no 6, 2461-2465 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate birth rates with two oxygen (O(2)) concentrations in blastocyst culture. DESIGN: Randomized trial. SETTING: Private in vitro fertilization (IVF) clinic. PATIENT(S): Six hundred women undergoing IVF. INTERVENTION(S): Blastocyst culture in atmospheres with either 6% carbon dioxide (CO(2)) in air, the equivalent to 19% O(2), a two-gas system; or 5% O(2), 6% CO(2), and 90% nitrogen (N(2)), a three-gas system. MAIN OUTCOME MEASURE(S): Birth rate. RESULT(S): The inclusion criterion for blastocyst culture (at least five fertilized oocytes) was fulfilled in 396 women, randomized to 197 cultures with the three-gas system and 199 cultures with the two-gas system. The outcome with the three-gas system compared with the two-gas system showed a statistically significantly increased blastocyst rate (47.8% vs. 42.1%), mean number of blastocysts (3.8 vs. 3.3), and number of cryopreserved blastocysts (1.7 vs. 1.1). The mean number of transferred blastocysts was 1.2 versus 1.3. Culture with the three-gas system increased the relative birth rate by 10% compared with the two-gas system (42% vs. 32%, respectively), a statistically significant difference. The overall twin rate was 4.8%. CONCLUSION(S): Blastocyst culture with low-oxygen (5%) versus high-oxygen (19%) concentration yielded a better blastocyst outcome and a marked improvement in birth rate. Generation of cytotoxic reactive oxygen species with prolonged embryo culture might deteriorate blastocyst viability.

Place, publisher, year, edition, pages
2009. Vol. 91, no 6, 2461-2465 p.
Keyword [en]
blastocysts, gas atmosphere, In vitro fertilization, oxygen
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-105723DOI: 10.1016/j.fertnstert.2008.03.051ISI: 000266801400027PubMedID: 18554591OAI: oai:DiVA.org:uu-105723DiVA: diva2:222328
Available from: 2009-06-08 Created: 2009-06-08 Last updated: 2017-12-13Bibliographically approved

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