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Purpose <p>To evaluate whether reduced oxygen tension (5% O<sub>2</sub>) during embryo culture is associated with differences in neonatal outcomes compared with atmospheric oxygen (20% O<sub>2</sub>) in fresh IVF/ICSI singleton births.</p> Methods <p>We conducted a retrospective cohort study at Peking University Third Hospital (2015–2022), including 13,831 singleton live births after fresh cleavage-stage transfers. Neonates conceived under 5% O<sub>2</sub> (<i>n</i> = 3192) were compared with 20% O<sub>2</sub> (<i>n</i> = 10,639). Primary outcomes were gestational age, birthweight, and gestational age and sex-adjusted <i>Z</i>-scores; secondary outcomes included small-for-gestational-age (SGA), large-for-gestational-age (LGA), and macrosomia. Multivariable regression adjusted for maternal/paternal age, body mass index (BMI), infertility type, stimulation protocol, gonadotropin dose, fertilization method, endometrial thickness, number of embryos transferred, and culture medium. Birthweight-related outcomes were further adjusted for gestational age and sex.</p> Results <p>Compared with 20% O<sub>2</sub>, 5% O<sub>2</sub> was associated with longer gestation (<i>β</i> = 0.073&#xa0;weeks; <i>P</i> = 0.009), lower birthweight (<i>β</i> =  − 44.6&#xa0;g; <i>P</i> &lt; 0.001), and lower <i>Z</i>-scores (<i>β</i> =  − 0.105; <i>P</i> &lt; 0.001). SGA risk increased (OR = 1.26; <i>P</i> = 0.030), while LGA (OR = 0.80; <i>P</i> &lt; 0.001) and macrosomia (OR = 0.81; <i>P</i> = 0.006) decreased; preterm birth did not differ.</p> Conclusions <p>Reduced oxygen tension during embryo culture was associated with lower neonatal birthweight and a reduced incidence of LGA or macrosomic infants, indicating a favorable effect on neonatal outcomes. Prospective multicenter and mechanistic studies are warranted to confirm these findings and refine oxygen management in Assisted reproductive technologies (ART).</p>

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Reduced oxygen tension during embryo culture and neonatal growth outcomes: a large retrospective cohort study of 13,831 fresh IVF/ICSI singleton births

  • 期刊论文

  • 发表日期：

    2025年12月5日

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  • Li Lei,
  • Ming Li,
  • Qingqing Tao,
  • Jin Huang,
  • Qin Li,
  • Ying Lian,
  • Jie Qiao,
  • Rong Li,
  • Ping Liu

摘要

Purpose

To evaluate whether reduced oxygen tension (5% O2) during embryo culture is associated with differences in neonatal outcomes compared with atmospheric oxygen (20% O2) in fresh IVF/ICSI singleton births.

Methods

We conducted a retrospective cohort study at Peking University Third Hospital (2015–2022), including 13,831 singleton live births after fresh cleavage-stage transfers. Neonates conceived under 5% O2 (n = 3192) were compared with 20% O2 (n = 10,639). Primary outcomes were gestational age, birthweight, and gestational age and sex-adjusted Z-scores; secondary outcomes included small-for-gestational-age (SGA), large-for-gestational-age (LGA), and macrosomia. Multivariable regression adjusted for maternal/paternal age, body mass index (BMI), infertility type, stimulation protocol, gonadotropin dose, fertilization method, endometrial thickness, number of embryos transferred, and culture medium. Birthweight-related outcomes were further adjusted for gestational age and sex.

Results

Compared with 20% O2, 5% O2 was associated with longer gestation (β = 0.073 weeks; P = 0.009), lower birthweight (β =  − 44.6 g; P < 0.001), and lower Z-scores (β =  − 0.105; P < 0.001). SGA risk increased (OR = 1.26; P = 0.030), while LGA (OR = 0.80; P < 0.001) and macrosomia (OR = 0.81; P = 0.006) decreased; preterm birth did not differ.

Conclusions

Reduced oxygen tension during embryo culture was associated with lower neonatal birthweight and a reduced incidence of LGA or macrosomic infants, indicating a favorable effect on neonatal outcomes. Prospective multicenter and mechanistic studies are warranted to confirm these findings and refine oxygen management in Assisted reproductive technologies (ART).