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The effects of daily meteorological perturbation on pregnancy outcome: follow-up of a cohort of young women undergoing IVF treatment
Environmental Health ( IF 5.3 ) Pub Date : 2019-11-28 , DOI: 10.1186/s12940-019-0538-7
Mingpeng Zhao 1 , Haoyang Zhang 2 , Tarah H B Waters 1 , Jacqueline Pui Wah Chung 1 , Tin Chiu Li 1 , David Yiu Leung Chan 1
Affiliation  

Human reproduction follows a seasonal pattern with respect to spontaneous conception, a phenomenon wherein the effect of meteorological fluctuations might not be unique. However, the effect of seasonal variations on patients who underwent in vitro fertilization (IVF) treatment is unclear. We aimed to evaluate the effects of meteorological variation on the pregnancy rate in a cohort undergoing IVF treatment by performing multivariable analyses. We conducted a cohort study in a sub-tropical region with prominent seasonal variations (2005–2016). Women aged < 35 years who were treated with a long ovarian stimulation protocol and underwent fresh embryo transfer (ER) were included. Data on gonadotropin administration (CYCL), oocyte retrieval (OR), ER, and pregnancy outcomes were prospectively recorded. For each patient, the daily average of meteorological data (temperature, humidity, sunlight duration, solar radiation) was recorded from the date of CYCL to ER. Multiple logistic regression analysis adjusted for age, fertilization method, year of the cycle, gonadotropin dose, and transferred embryo grade was performed to determine the relationship between the meteorological parameters and clinical pregnancy. Patients with one successful cycle and one failed cycle were subtracted for a case-control subgroup analysis through mixed effect logistics regressions. Time-series analysis of data in the epidemic level was conducted using the distributed lag linear and non-linear models (DLNMs). There were 1029 fresh cycles in 860 women (mean age 31.9 ± 2.0 years). Higher mean temperature from CYCL to OR (adjusted odds ratio [aOR] 1.04; 95% confidence interval [CI] 1.01–1.07, P = 0.01) increased the odds of pregnancy, while OR to ER did not show any statistical significance. Compared to that in winter, the odds of becoming pregnant were higher during higher temperature seasons, summer and autumn (aOR 1.47, 95%CI 0.97–2.23, P = 0.07 (marginally significant) and aOR 1.73, 95%CI 1.12–2.68, P = 0.02, respectively). Humidity, sunlight duration, and solar radiation had no effect on the outcome. The subgroup analysis confirmed this finding. The time-series analysis revealed a positive association between temperature and relative risk for pregnancy. In IVF treatment, the ambient temperature variation alters the pregnancy rates; this aspect must be considered when obtaining patient consent for assisted conception.

中文翻译:


每日气象扰动对妊娠结局的影响:对接受 IVF 治疗的年轻女性队列的随访



人类的繁殖遵循自然受孕的季节性模式,这种现象中气象波动的影响可能不是唯一的。然而,季节变化对接受体外受精(IVF)治疗的患者的影响尚不清楚。我们的目的是通过进行多变量分析来评估气象变化对接受 IVF 治疗的队列妊娠率的影响。我们在季节性变化显着的亚热带地区(2005-2016)进行了一项队列研究。年龄为 < 35 岁的女性接受了长期卵巢刺激方案治疗并接受了新鲜胚胎移植 (ER)。前瞻性记录促性腺激素给药 (CYCL)、卵母细胞取出 (OR)、ER 和妊娠结局的数据。对于每位患者,从 CYCL 日期到 ER 日期记录每日平均气象数据(温度、湿度、日照时间、太阳辐射)。对年龄、受精方法、周期年份、促性腺激素剂量和移植胚胎等级进行多元逻辑回归分析,以确定气象参数与临床妊娠之间的关系。通过混合效应逻辑回归,减去一个成功周期和一个失败周期的患者进行病例对照亚组分析。使用分布式滞后线性和非线性模型(DLNM)对流行病级别的数据进行时间序列分析。 860 名女性(平均年龄 31.9 ± 2.0 岁)进行了 1029 个新鲜周期。从 CYCL 到 OR 的平均温度较高(调整后优势比 [aOR] 1.04;95% 置信区间 [CI] 1.01–1.07,P = 0.01)增加了怀孕的几率,而 OR 到 ER 没有显示任何统计显着性。 与冬季相比,高温季节、夏季和秋季的怀孕几率较高(aOR 1.47,95%CI 0.97–2.23,P = 0.07(边际显着),aOR 1.73,95%CI 1.12–2.68, P = 0.02,分别)。湿度、日照时间和太阳辐射对结果没有影响。亚组分析证实了这一发现。时间序列分析显示温度与相对怀孕风险之间呈正相关。在 IVF 治疗中,环境温度的变化会改变妊娠率;在获得患者同意进行辅助受孕时必须考虑这一方面。
更新日期:2020-04-22
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