“Can FET and fresh ET outcome in IVF cycles be affected by the open environment air pollution?”

INTRODUCTION: IVF outcomes and human infertility can be a result of air pollution around us. It’s indicated in Choe et al [1] study that lower pregnancy rates in IVF cycles can be associated with ambient air pollution while controlled ovarian stimulation as well as the post-transfer period. Choe et al1 study indicated lower pregnancy rates in IVF cycles may be linked to ambient air pollution during controlled ovarian stimulation and the post-transfer period. Do the outcomes of frozen-thawed embryo transfer (FET) and fresh transfer are differentially affected by open-air pollution?

SUMMARY:Between January 2013 and December 2016, Wang et al [2] studied the adverse effects of air pollution in 11148 patients contributing to 16290 transfer cycles for IVF treatment cycles. The average age of the cohort was recorded to be 31.5 years. In order to estimate the daily ambient exposures to six main pollutants ( CO, O 3 , SO 2 , NO 2 , PM 2.5 , PM 10 ) inverse distance weighing interpolation was used at an IVF clinical site, bestow to the data recorded at the fixed air quality monitoring stations inside the city. The exposure for every cycle was shown as the daily mean concentration of contaminants (pollutants) from oocyte retrieval to embryo transfer/cryopreservation. Analysis of exposures was performed on every quarter basis. A general equating estimate was used to study the relationship between pollutants and IVF results. The rate of clinical pregnancy and the rate of live birth of the course were recorded to be 55.1% and 47.1% respectively. 4013 patients among the included cycles, got 5299 FET cycles, bringing about 42.7% live birth per ET, while 9553 patients got 10991 new transfer cycles, bringing about 49.2% to live birth per ET. Raised SO 2 and O 3 levels were essentially related with lower rates of live birth in FET cycles, while none of the pollutants was significantly linked with bringing down of IVF results in new transfer cycles. The FET cycles in the most elevated quartile of SO 2 and O 3 exposure had essentially lower rates of live birth (balanced OR) in correlation with those in the least quartile. Models including all transfer cycles and collaboration terms (FET exposures) recommended that FET altogether improved the impacts of SO 2 and O 3 exposures on IVF results (P < 0.001). Representing every six contaminations, women in the top quartile of SO 2 still had the least rates of live birth (OR 0.61, 95%CI 0.47–0.80).

CONCLUSION: According to this study, embryos may be more vulnerable to a suboptimal environment which are undergoing FET in comparison to those which are undergoing fresh transfer. Elevated SO 2 and O 3 levels at the location of IVF were found to be significantly linked with lower rates of live birth following FET whereas it did not show any adverse effect on the contemporary new transfer results. In the locations and seasons which are heavily polluted, due to dynamic changes of the ambient air pollutant (specifically gaseous), fluctuation in FET outcomes can be seen.

REFERENCES: 1. Xin Li Wang, Jiali Cai, Lanlan Liu, Xiaoming Jiang, Ping Li, Aiguo Sha, Jianzhi Ren; Association between outdoor air pollution during in vitro culture and the outcomes of frozen-thawed embryo transfer, Human Reproduction, Volume 34, Issue 3, 1 March 2019, Pages 441–451, https://doi.org/10.1093/humrep/dey386
2. Choe SA, Jun YB, Lee WS, Yoon TK, Kim SY. Association between ambient air pollution and pregnancy rate in women who underwent IVF. Hum Reprod. 2018 Jun 1;33(6):1071-1078. doi: 10.1093/humrep/dey076. PubMed PMID: 29659826

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