Associations of sleep characteristics with outcomes of IVF/ICSI treatment: a prospective cohort study.
Level 3 - non-randomized controlled study
Prospective observational cohort study
PubMed 35259255 · doi:10.1093/humrep/deac040
What was done
A prospective cohort study analyzed 1,276 women undergoing their first IVF/ICSI cycle at a Chinese reproductive center between December 2018 and September 2019. Sleep characteristics were assessed using questionnaires administered on the day of oocyte retrieval. Clinical outcomes were abstracted from medical records. Quasi-Poisson, quasi-binomial, and logistic regression models adjusted for confounders evaluated associations between sleep parameters and reproductive endpoints, with subgroup analyses by maternal age and subjective sleep quality.
What was found
Compared with sleeping 7 to <8 h/night, sleeping <7 h/night was associated with an 11.5% reduction in retrieved oocytes (95% CI: -21.3%, -0.48%) and an 11.9% reduction in mature oocytes (95% CI: -22.4%, -0.03%). Mid-sleep time <2:21 a.m. or ≥3:00 a.m. and poor subjective sleep quality were inversely associated with fertilization rate. Trouble falling asleep >3 times/week was associated with fewer mature oocytes (-10.5%, 95% CI: -18.6%, -1.6%), fewer normally fertilized oocytes (-14.8%, 95% CI: -23.7%, -4.8%), and fewer good-quality embryos (-15.1%, 95% CI: -25.4%, -3.5%). Sleeping 9 to <10 h/night was associated with lower clinical pregnancy odds (OR = 0.65, 95% CI: 0.44, 0.98) relative to 7 to <8 h/night, though longer sleep was positively associated with clinical pregnancy in women older than 30 years (P for interaction = 0.01).
Why it matters
The findings identify specific sleep disturbances—including short duration, timing extremes, and sleep onset latency—as potential modifiable factors linked to poorer oocyte yield and embryo development in assisted reproduction.
Limits
Sleep characteristics were entirely self-reported at the time of oocyte retrieval, introducing potential recall and acute procedural stress bias. Sample sizes in extreme sleep duration categories (<7 h and ≥10 h) were small, multiple comparisons increase the risk of chance findings, and results may not generalize beyond Chinese IVF patients.
Cited by
- supports Women who get less sleep yield fewer eggs during an IVF retrieval cycle.