Association between season and pregnancy outcomes in fresh embryo transfer cycles: a systematic review and meta-analysis
Bibliographic record
Abstract
Background Infertility represents a major global public health challenge. Identifying modifiable factors to optimize the outcomes of assisted reproductive technology (ART) is therefore crucial. Seasonal exposure has been reported to be correlated with natural conception rates, birth patterns, and adverse pregnancy outcomes. However, the potential associations between seasonal exposure and pregnancy outcomes among women undergoing fresh embryo transfer cycles remain controversial. This study aims to determine whether an association exists between seasonal exposure and pregnancy outcomes following fresh embryo transfer cycles, thereby providing evidence-based guidance on whether seasonal considerations should be integrated into ART treatment planning. Methods This review adhered to the PRISMA guidelines. Literature searches were conducted across seven major electronic databases. Data synthesis employed either fixed-effects models. Subgroup analyses were performed according to the Köppen climate classification. The risk of bias in the included studies was assessed using the Newcastle-Ottawa Scale (NOS). Associations are reported as odds ratios (ORs) with corresponding 95% confidence intervals (CIs), and heterogeneity was quantified using the I 2 statistic. Results A total of 19 retrospective studies encompassing 159,696 fresh embryo transfer cycles were included. Overall, no significant associations were found between season and clinical pregnancy or live birth. Subgroup analyses, however, revealed climate-specific variations: In Cwa (humid subtropical) climates, live birth rates were significantly higher in summer than in winter (OR = 1.05; 95% CI, 1.01–1.10; I 2 = 0%, P heterogeneity < 0.05). In Dfb (warm–summer humid continental) climates, live birth rates were significantly higher in spring than in summer (OR = 1.07; 95% CI, 1.01–1.14). Conclusion Seasonal variation exhibits no significant association with pregnancy outcomes following fresh embryo transfer cycles. The observed variations within specific climate subgroups may result from multifactorial influences and require further research for validation. Clinicians and patients can prioritize medical indications and personal readiness without concern that seasonal timing may adversely impact pregnancy outcomes. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251077751 , Identifier: CRD420251077751.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.033 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.015 | 0.033 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".