Abstract
Inadequate nutrition and lifestyle behaviors, particularly during the periconception period, are associated with a negative impact on embryonic and subsequent fetal development. We investigated the associations between parental nutritional and lifestyle factors and pre-implantation embryo development. A total of 113 women and 41 partners, with a corresponding 490 embryos, who underwent intracytoplasmic sperm injection (ICSI) treatment subscribed to the mHealth coaching platform “Smarter Pregnancy.” At baseline, nutrition and lifestyle behaviors (intake of fruits, vegetables, folic acid, and smoking and alcohol use) were identified and risk scores were calculated. A lower risk score represents healthier behavior. As outcome measure, a time-lapse morphokinetic selection algorithm (KIDScore) was used to rank pre-implantation embryo quality on a scale from 1 (poor) to 5 (good) after being cultured in the Embryoscope™ time-lapse incubator until embryonic day 3. To study the association between the nutritional and lifestyle risk scores and the KIDScore in men and women, we used a proportional odds model. In women, the dietary risk score (DRS), a combination of the risk score of fruits, vegetables, and folic acid, was negatively associated with the KIDScore (OR 0.86 (95% CI 0.76 to 0.98), p = 0.02). This could mainly be attributed to an inadequate vegetable intake (OR 0.76 (95% CI 0.59 to 0.96), p = 0.02). In men, smoking was negatively associated with the KIDscore (OR 0.53 (95% CI 0.33 to 0.85), p < 0.01). We conclude that inadequate periconceptional maternal vegetable intake and paternal smoking significantly reduce the implantation potential of embryos after ICSI treatment. Identifying modifiable lifestyle risk factors can contribute to directed, personalized, and individual recommendations that can potentially increase the chance of a healthy pregnancy.
Highlights
Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.Subfertility is still an increasing problem in the Western world, which can be attributed to postponing pregnancy, and to a decline in sperm count, increasing age of women at the time of conception, obesity, smoking, and other poor lifestyles [1,2,3]
After the introduction of the EmbryoScopeTM time-lapse incubator in our clinic, it was mostly used for cycles from patients undergoing intracytoplasmic sperm injection (ICSI) treatment, as in this situation, oocytes can be submitted to time-lapse culture directly after injection and resulting embryos can benefit optimally from undisturbed culture
We showed that inadequate maternal vegetable and fruit intake, as well as paternal smoking during the periconception period, are associated with the quality and developmental morphokinetics of pre-implantation embryos as outcome of implantation potential
Summary
Subfertility is still an increasing problem in the Western world, which can be attributed to postponing pregnancy, and to a decline in sperm count, increasing age of women at the time of conception, obesity, smoking, and other poor lifestyles [1,2,3]. Despite novel developments in assisted reproductive technology (ART), high rates of implantation failure and early pregnancy loss are still seen after the transfer of selected, morphologically high quality, pre-implantation embryos [4]. Pre-implantation embryo development can be studied using the EmbryoScopeTM, which incorporates a specialized built-in microscope designed for automated time-lapse embryo assessment by acquiring images [5]. The EmbryoScopeTM provides a controlled culture environment and captures comprehensive information on embryo development without the need for handling or disturbing the developing embryo.
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