Culture media for human pre-implantation embryos in assisted reproductive technology cycles

Youssef, Mohamed M A; Mantikou, Eleni; Wely, Madelon van; Veen, Fulco van der; Al-Inany, Hesham; Repping, Sjoerd

doi:10.1002/14651858.cd007876.pub2

Cited by 42 publications

(24 citation statements)

References 89 publications

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“…Therefore, we performed this systematic review in an attempt to determine whether there is sufficient evidence to prove that one culture medium system for culturing human embryos is superior to another. Unlike a recent Cochrane Review that also evaluated the efficacy of various media for culturing human preimplantation embryos [1], this present review is focused exclusively on comparing single versus sequential media for culturing embryos to the blastocyst stage.…”

Section: Introductionmentioning

confidence: 99%

Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials

Sfontouris

Martins

Nastri

et al. 2016

J Assist Reprod Genet

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Purpose The purpose of this study was to undertake a review of the available evidence comparing the use of a single medium versus sequential media for embryo culture to the blastocyst stage in clinical IVF. Methods We searched the Cochrane Central, PubMed, Scopus, ClinicalTrials.gov, Current Controlled Trials and WHO International Clinical Trials Registry Platform to identify randomized controlled trials comparing single versus sequential media for blastocyst culture and ongoing pregnancy rate. Included studies randomized either oocytes/zygotes or women. Eligible oocyte/zygote studies were analyzed to assess the risk difference (RD) and 95 % confidence intervals (CI) between the two media systems; eligible woman-based studies were analyzed to assess the risk ratio (RR) and 95 % CI for clinical pregnancy rate. Results No differences were observed between single and sequential media for either ongoing pregnancy per randomized woman (relative risk (RR) = 0.9, 95 % CI = 0.7 to 1.3, two studies including 246 women, I 2 = 0 %) or clinical pregnancy per randomized woman (RR = 1.0, 95 % CI = 0.7 to 1.4, one study including 100 women); or miscarriage per clinical pregnancy: RR = 1.3, 95 % CI = 0.4 to 4.3, two studies including 246 participants, I 2 = 0 %). Single media use was associated with an increase blastocyst formation per randomized oocyte/ zygote (relative distribution (RD) = +0.06, 95 % CI = +0.01 to Declaration of Authors' Roles Conception and design (CR, LR, WPM, IAS, and NR-F); search strategy (WPM, IAS); data extraction (WPM, PAN, IGRV, CON), analysis, and interpretation (all authors); writing the article (all authors). All authors had full access to all the data in the study and approved the final manuscript.Capsule In conclusion, there is insufficient evidence to recommend either sequential or single-step media as being superior for the culture of embryos to days 5/6 blastocyst stage. +0.12, ten studies including 7455 oocytes/zygotes, I 2 = 83 %) but not top/high blastocyst formation (RD = +0.05, 95 % CI = −0.01 to +0.11, five studies including 3879 oocytes/zygotes, I 2 = 93 %). The overall quality of the evidence was very low for all these four outcomes. Electronic supplementary materialConclusions Although using a single medium for extended culture has some practical advantages and blastocyst formation rates appear to be higher, there is insufficient evidence to recommend either sequential or single-step media as being superior for the culture of embryos to days 5/6. Future studies comparing these two media systems in well-designed trials should be performed.

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Section: Introductionmentioning

confidence: 99%

Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials

Sfontouris

Martins

Nastri

et al. 2016

J Assist Reprod Genet

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“…Although many studies have been carried out about embryo culture media, a recent review (Youssef et al ., 2015) concluded for the lack of evidence to support or refute the use of any specific culture medium.…”

Section: Introductionmentioning

confidence: 99%

A descriptive study of culture media in Brazilian assisted reproduction clinics

Bartmann

Amaral

Gonçalves

2016

JBRA Assisted Reproduction

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ObjectiveThe present study aimed to draw a profile of the most commonly used media and protocol characteristics from assisted reproduction technology (ART) facilities in Brazil.MethodsTo obtain an overview of ART methods and culture media, a questionnaire was given to embryologists from ART clinics in Brazil. Further research in scientific papers and journals was carried out for describing the processes around Brazil, USA and Europe.ResultsFrom the questionnaire, we found that the embryo medium mostly used is CSCMTM from Irvine Scientific, represented 37.04% in Brazilian ART clinics; interestingly, 70.37% of clinics exchange the embryo media bath; however, 70.37% do not change the media type. Transfers in Brazilian clinics were variable, but day 3 transfer was a procedure seen in 37.04%. The remaining embryos are habitually maintained in prolonged cultivation in 51.85% of the clinics interviewed.ConclusionAlthough there are numerous studies trying to better understand embryo culture media influences, there is a lack of evidence for choosing one as the most appropriate. In short, it is a random decision for such an essential stage of In Vitro Fertilization.

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“…Women included in this study were 18-37 years of age with body mass index (BMI) %31 kg/m 2 and normal response to stimulation with ten or more follicles (seven or more mature oocytes expected) as well as normal endometrial thickness (8)(9)(10)(11)(12) and echographic pattern at the time of the hCG trigger. They were undergoing their first treatment cycle or had had a previous successful treatment cycle.…”

Section: Methodsmentioning

confidence: 99%

“…Over the past decades, endeavors to determine the optimal medium have followed two main approaches: the ''sequential media'' paradigm which provides the developing embryo with stage-specific nutrients, and ''single-step'' medium formulation that provides all of the required nutrients continuously (8). However, to date, neither approach has produced a clearly superior medium (9,10). Using unconditioned culture media, which contain embryotrophic factors, such as cytokines, steroid hormones, growth factors, and insulin, results in better preimplantation embryo development in vitro (11)(12)(13)(14).…”

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confidence: 99%

Integrating insulin into single-step culture medium regulates human embryo development in vitro

Fawzy¹,

Sabry

Nour

et al. 2017

Fertility and Sterility

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Culture media for human pre-implantation embryos in assisted reproductive technology cycles

Cited by 42 publications

References 89 publications

Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials

Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials

A descriptive study of culture media in Brazilian assisted reproduction clinics

Integrating insulin into single-step culture medium regulates human embryo development in vitro

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