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To assess the associations between air pollution and the pregnancy rate of IVF, we performed a retrospective cohort study on 1455 women who underwent the first fresh IVF cycle at a fertility center from January 2014 to April 2018 and lived in Shenyang during treatment. Binary logistic regression models were used to evaluate the effect of an interquartile range increase in each pollutant on the intrauterine pregnancy rate. Both average chronic and daily acute exposure to air pollution were considered. Increased O 3 (adjusted OR = 0.87, 95% CI: 0.81, 0.98) during the period from gonadotropins starting to oocyte retrieval was associated with decreased probability of intrauterine pregnancy, especially the day before oocyte retrieval (adjusted OR = 0.86, 95% CI: 0.78, 0.95). Our results suggest that exposure to O 3 before oocyte retrieval has an adverse effect on intrauterine pregnancy. Future studies should be performed in order to confirm our findings., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Infertility has become a global health issue with the number of couples seeking in vitro fertilization (IVF) worldwide continuing to rise. Some couples remain childless after several IVF cycles. Women undergoing IVF face greater risks and financial burden. A prediction model to predict the live birth chance prior to the first IVF treatment is needed in clinical practice for patients counselling and shaping expectations., Methods: Clinical data of 7188 women who underwent their first IVF treatment at the Reproductive Medical Center of Shengjing Hospital of China Medical University during 2014-2018 were retrospectively collected. Machine-learning based models were developed on 70% of the dataset using pre-treatment variables, and prediction performances were evaluated on the remaining 30% using receiver operating characteristic (ROC) analysis and calibration plot. Nested cross-validation was used to make an unbiased estimate of the generalization performance of the machine learning algorithms., Results: The XGBoost model achieved an area under the ROC curve of 0.73 on the validation dataset and showed the best calibration compared with other machine learning algorithms. Nested cross-validation resulted in an average accuracy score of 0.70 ± 0.003 for the XGBoost model., Conclusions: A prediction model based on XGBoost was developed using age, AMH, BMI, duration of infertility, previous live birth, previous miscarriage, previous abortion and type of infertility as predictors. This study might be a promising step to provide personalized estimates of the cumulative live birth chance of the first complete IVF cycle before treatment.

Toxic and essential trace elements are associated with human fertility. However, limited studies have been conducted on the relationship between trace elements and in vitro fertilization (IVF) outcomes in the Chinese population. In this exploratory study, 103 couples who underwent IVF/intracytoplasmic sperm injection (ICSI) treatment in our reproductive center were recruited. Serum and follicular fluid (FF) samples and seminal plasma samples were collected from the female and male partners, respectively, on the day of oocyte retrieval. Concentrations of chromium (Cr), nickel (Ni), arsenic (As), selenium (Se), cadmium (Cd), and lead (Pb) in the specimens were measured by inductively coupled plasma-mass spectrometry. Generalized linear models were used to evaluate the associations of toxic and essential trace element levels with the intermediate parameters and outcomes of IVF at both the sex-specific and couple levels. The Cr level in the serum of the female partners was inversely associated with the count of mature oocytes retrieved (p for trend = 0.033). In terms of embryo development, As concentrations in female serum and FF were inversely associated with the probabilities to obtain good-quality cleavage embryos (p for trend < 0.01). There were significant correlations between follicular Se concentrations and seminal As concentrations and higher quality cleavage embryos (p for trend < 0.01). Moreover, a positive correlation was observed between the female serum Se concentrations and blastocyst formation (p for trend = 0.031). In contrast, a higher follicular Se level was negatively correlated with embryo development at the blastocyst stage (p for trend < 0.01). Regarding the clinical outcomes, a positive association of Se levels in seminal plasma and a negative association of follicular Cd levels was observed with the probabilities of pregnancy (p for trend = 0.006 and 0.035, respectively) and live birth (p for trend = 0.014 and 0.027, respectively). The results indicate that exposure to toxic elements (Cr, As and Cd) is associated with intermediate parameters and outcomes of IVF. Furthermore, male Se exposure may be related to better pregnancy outcomes. • Associations of toxic and essential trace elements with IVF outcomes were explored. • This is first study to integrate male and female exposures to multiple trace elements. • Seminal Se levels were positively associated with pregnancy and live birth. • Follicular Cd levels were negatively associated with pregnancy and live birth. • Female serum Se levels were positively associated with blastocyst development. [ABSTRACT FROM AUTHOR]

• The first large-scale multicenter retrospective study conducted in Northern China. • Both outcomes of fresh and frozen-thawed embryo transfer cycles in IVF were explored. • Exposure to O 3 , CO, and NO 2 are negatively associated with fresh transfer outcomes. • SO 2 exposure is inversely correlated with pregnancy outcomes in FET cycles. • Air pollution is associated with higher risk of ectopic pregnancy and lower oocyte yield. Exposure to ambient air pollution has been reported to be inversely correlated with human reproductive health. However, the results of previous studies exploring the association between air pollution and in vitro fertilization (IVF) outcomes are conflicting, and further research is needed to clarify this association. This study aimed to investigate the associations between exposure to air pollutants and IVF outcomes. We conducted a multicenter retrospective cohort study involving 20,835 patients from four cities in Northern China, contributing to 11,787 fresh embryo transfer cycles, 9050 freeze-all cycles, and 17,676 frozen-thawed embryo transfer (FET) cycles during 2014–2018. We calculated the daily average concentrations of six criteria air pollutants (PM 2.5 , PM 10 , O 3 , NO 2 , CO, and SO 2) during different exposure windows in IVF treatment timeline using data from the air monitoring station nearest to the residential site as approximate individual exposure. Generalized estimation equation models were used to assess the association between air pollution exposure and IVF outcomes. Exposure to O 3 , NO 2 , and CO during most exposure windows in fresh embryo transfer cycles were correlated with lower possibilities of biochemical pregnancy, clinical pregnancy, and live birth. An inverse association of exposure to O 3 and SO 2 with pregnancy outcomes was observed in FET cycles. In addition, we found a significant association of exposure to air pollutants with a higher risk of ectopic pregnancy and lower oocyte yield. Our study provided large-scale human evidence of the association between air pollution and adverse human reproductive outcomes in the population opting for IVF. Thus, exposure to air pollutants in the population opting for IVF should be limited to improve treatment outcomes. [ABSTRACT FROM AUTHOR]