Impact of Living in Different Altitudes on Intracytoplasmic Sperm Injection (ICSI) Outcomes for Infertile Couples in Southwestern Region of Saudi Arabia, a Retrospective Study

Objective: The aim of this study was to determine the effect of different altitudes in the Southwestern region of Saudi Arabia on ICSI outcomes, fertilization rate, embryo quality, pregnancy rate, and miscarriage rates for infertile couples. Materials and Methods: This is a retrospective study on 551 infertile couples carried out in the Assisted Reproductive Technology unit at the Maternity and Childern Hospital in Abha, Saudi Arabia between 2018 and 2019 to compare ICSI outcomes in different altitudes. Low altitude (205 patients), mild altitude (86 patients) and high altitude (260 patients). Main result measurements: fertilization rates, embryo quality, clinical pregnancy and miscarriage rates at different altitudes. Results: The data showed that there were no significant differences (P>0.67) in fertilization rates and the number of good-quality embryos between different altitudes. Importantly, clinical pregnancy rates were similar between groups and there was no significant difference in the miscarriage rates between high, mild and low altitudes. Conclusions: This study demonstrates that there is now increased risk of miscarriage or low pregnancy rates with different altitudes in Southwestern region of Saudi Arabia. This suggests that altitude changes has no obvious risk on pregnancy rate and pregnancy outcome.