Promising Perinatal Outcome after Using a Simplified Low-Cost IVF Culture System Specifically Designed for Resource-Poor Countries

Willem Ombelet; Jonathan Van Blerkom; Liesbeth Bruckers; Nathalie Dhont; Geeta Nargund; Rudi Campo

doi:10.3390/jcm12062264

Promising Perinatal Outcome after Using a Simplified Low-Cost IVF Culture System Specifically Designed for Resource-Poor Countries

J Clin Med. 2023 Mar 15;12(6):2264. doi: 10.3390/jcm12062264.

Authors

Willem Ombelet^{1

2}, Jonathan Van Blerkom³, Liesbeth Bruckers⁴, Nathalie Dhont¹, Geeta Nargund⁵, Rudi Campo^{1

6}

Affiliations

¹ Department of Obstetrics and Gynaecology, Genk Institute for Fertility Technology, ZOL Hospitals, 3600 Genk, Belgium.
² Faculty of Medicine and Life Sciences, Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium.
³ Department of Molecular, Cellular and Developmental Biology, University of Colorado, Boulder, CO 80309, USA.
⁴ BioStat, Data Science Institute, Hasselt University, 3500 Hasselt, Belgium.
⁵ St. Georges Hospital& Medical School, London SW17 0QT, UK.
⁶ Life Expert Centre, Schipvaartstraat 4, 3000 Leuven, Belgium.

Abstract

Background: Assisted reproductive techniques services are often not accessible to the majority of infertile couples in Low and Middle Income Countries (LMIC) due to high costs. Lowering IVF laboratory costs is a crucial step to make IVF affordable for a larger part of the world population. We developed a simplified culture system (SCS) which has proven to be effective, and the next step is to prove its safety.

Methods: Preterm birth (PTB) and low birthweight (LBW) of 176 singletons born after using the SCS, 105 after fresh embryo transfer (fresh ET), and 71 after frozen embryo transfer (frozen ET) were compared with all IVF/ICSI singletons born in Belgium between 2013 and 2018. When comparing our 105 SCS babies born after fresh ET with all Belgian babies born after conventional IVF only, we also adjusted for 7 risk factors known to influence perinatal outcome, namelythe mother's age, day of transfer, pituitary inhibition protocol, rank of cycles, number of oocytes retrieved, number of embryos transferred, and gender of the baby.

Findings: Before adjustment, we found a significantly higher PTB (10.2% vs. 3.8%, OR 2.852, 95% CI [1.042-7.803], p-value 0.0413) and LBW (9.8% vs. 2.9%, OR 3.692, 95% CI [1.163-11.721], p-value 0.0267) in the conventional IVF group versus SCS after fresh ET. After adjusting for seven risk parameters, these differences remained significant (PTB: OR 2.627, 95% CI [1.013-6.816], p-value 0.0471) and LBW: OR 3.267, 95% CI [1.118-9.549], p-value 0.0305). PTB and LBW between both groups was not significantly different for singletons born after frozen ET.

Interpretation: Taking into account the small series, PTB and LBW rates in SCS singletons in FRET cycles are very reassuring and significantly lower compared to babies born after conventional IVF in Belgium. Being aware of its effectiveness, our results offer a good perspective for SCS to become an important tool to implement low-cost IVF in LMIC.

Keywords: IVF; LMIC; assisted reproduction; developing countries; infertility care; low-cost IVF; simplified IVF.

Grants and funding

This research received no external funding.