Blastocyst utilization rates after continuous culture in two commercial single-step media: a prospective randomized study with sibling oocytes
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The aim of this study is to determine whether blastocyst utilization rates are different after continuous culture in two different commercial single-step media.
This is a paired randomized controlled trial with sibling oocytes conducted in infertility patients, aged ≤40 years with ≥10 oocytes retrieved assigned to blastocyst culture and transfer. Retrieved oocytes were randomly allocated to continuous culture in either Sage one-step medium (Origio) or Continuous Single Culture (CSC) medium (Irvine Scientific) without medium renewal up to day 5 post oocyte retrieval. Main outcome measure was the proportion of embryos suitable for clinical use (utilization rate).
A total of 502 oocytes from 33 women were randomly allocated to continuous culture in either Sage one-step medium (n = 250) or CSC medium (n = 252). Fertilization was performed by either in vitro fertilization or intracytoplasmic sperm injection, and embryo transfers were performed on day 5. Two patients had all blastocysts frozen due to the occurrence of severe ovarian hyperstimulation syndrome. Fertilization and cleavage rates, as well as embryo quality on day 3, were similar in the two media. Blastocyst utilization rates (%, 95% CI) [55.4% (46.4–64.1) vs 54.7% (44.9–64.6), p = 0.717], blastocyst formation rates [53.6% (44.6–62.5) vs 51.9 (42.2–61.6), p = 0.755], and proportion of good quality blastocysts [36.8% (28.1–45.4) vs 36.1% (27.2–45.0), p = 0.850] were similar in Sage one-step and CSC media, respectively.
Continuous culture of embryos in Sage one-step and CSC media is associated with similar blastocyst development and utilization rates. Both single-step media appear to provide adequate support during in vitro preimplantation embryo development. Whether these observations are also valid for other continuous single medium protocols remains to be determined.
Clinical trial registration number: NCT02302638.
KeywordsEmbryo culture Single step Continuous culture Blastocyst formation Utilization rate
The authors wish to thank Mrs. Maria Banti for embryology work and Mrs. G. Stavropoulou and Mrs. Ioanna Voulgaris for patient coordination.
IAS conceived the study, performed acquisition, analysis and interpretation of data, writing and revision of the manuscript, and embryology work. EMK, GTL, and CAV participated in the analysis and interpretation of data and writing and revision of the manuscript. GKP and BCT participated in the interpretation of data and revision of the manuscript. TGL had the general supervision of the study, participated in study design, analysis and interpretation of data, writing and revision of the manuscript, and performed clinical work. All authors read and approved the final manuscript.
Compliance with ethical standards
Sage one-step medium was provided by Origio, and CSC medium was provided by Biocare Europe.
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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