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夏令时期间进行的胚胎移植导致老年患者的活产率降低。

Embryo transfers performed during daylight savings time led to reduced live birth rates in older patients.

机构信息

Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Sibel Health, Chicago, IL, USA.

出版信息

J Assist Reprod Genet. 2023 Nov;40(11):2639-2647. doi: 10.1007/s10815-023-02920-x. Epub 2023 Sep 5.

Abstract

PURPOSE

To study the impact of undergoing an embryo transfer during the week of daylight savings time transition on live birth rates.

METHODS

We performed a retrospective observational cohort study of patients undergoing embryo transfer at an academic infertility practice during the week of spring or fall daylight savings time transition (cases), or the 2 weeks preceding and following the daylight savings transition (controls) between 2015 and 2021. The primary exposure was completion of an embryo transfer during the week of daylight savings time transition. The primary outcome was a comparison of live birth rate per embryo transfer among individuals undergoing an embryo transfer during the week of daylight savings time (DST) transition and those who did not.

RESULTS

A total of 309 embryo transfers occurred during the week of daylight savings transition and 1242 embryo transfers occurred in the control group outside of the daylight savings transition week. The live birth rate after embryo transfer during DST transition weeks was 39.2% (121/309) compared to 40.8% (507/1242) (p = 0.59). When restricting the analysis to individuals (age > 37 years), the live birth rate after embryo transfer during DST transition week was 23.5% (24/102) compared to 34.8% (149/429) (p = 0.03). This difference persisted in the mixed-effects regression model demonstrating that after adjusting for relevant covariates, embryo transfer during DST transition weeks resulted in a 45% decrease in the odds of achieving a live birth.

CONCLUSION

Daylight savings time transition may be associated with less favorable outcomes after embryo transfer among an older infertile patient population. Future work is needed to prospectively examine the influence of circadian rhythm disruption on reproductive outcomes.

摘要

目的

研究在夏令时转换周进行胚胎移植对活产率的影响。

方法

我们对 2015 年至 2021 年期间在学术不孕不育诊所进行胚胎移植的患者进行了回顾性观察性队列研究,这些患者在夏令时或冬令时转换周(病例)的一周内,或在夏令时转换前后的两周内(对照组)进行胚胎移植。主要暴露因素是在夏令时转换周内完成胚胎移植。主要结局是比较夏令时转换周内进行胚胎移植的个体与未进行胚胎移植的个体的胚胎移植活产率。

结果

夏令时转换周内共进行了 309 次胚胎移植,对照组在夏令时转换周外共进行了 1242 次胚胎移植。夏令时转换周内胚胎移植后的活产率为 39.2%(121/309),而对照组为 40.8%(507/1242)(p=0.59)。当将分析限制在年龄>37 岁的个体时,夏令时转换周内胚胎移植后的活产率为 23.5%(24/102),而对照组为 34.8%(149/429)(p=0.03)。这种差异在混合效应回归模型中仍然存在,表明在调整了相关协变量后,夏令时转换周内进行胚胎移植会使活产的几率降低 45%。

结论

夏令时转换可能与年龄较大的不孕患者群体在胚胎移植后结果较差有关。需要进一步的前瞻性研究来检查昼夜节律紊乱对生殖结局的影响。

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