Better embryo quality and reproductive performance using sequential media in day 3 transfers

Abstract

Objective: To evaluate the reproductive performance of embryos cultured up to day 3 in an optimized, complex medium (HTF, Irvine, CA) compared with the use of a complex, sequential medium (G1.2 and G2.2, Vitrolife, Sweden).Design: A prospective, randomized comparison between two commercially available culture media.Materials and Methods: Two hundred ninety-four patients (all under 39 y.o. and with day 3 FSH level < 12 mIU/mL) were randomly assigned to HTF or G1.2-G2.2 for fertilization and embryo culture. HTF was supplemented with 5% human serum albumin. Embryos from both groups were cultured in microdroplets under oil in a 5.5% CO2, humidified atmosphere. Groups (HTF vs sequential) were comparable regarding female age (33.3 ± 3.8 vs 33.0 ± 3.3 years old), ovarian stimulation (long protocol with GnRH agonists and rFSH in a step down fashion), estradiol level on the day of the hCG administration (2290.5 ± 1084.4 vs 1911.4 ± 995.0 pg/mL), average number of mature oocytes (9.3 ± 4.4 vs 10.1 ± 5.1), percentage of ICSI procedures performed (50.0 vs 55.3) and average number of transferred embryos (3.6 ± 0.9 vs 3.6 ± 0.7). All transfers were performed on day 3. The average embryo quality was estimated as the ratio between the Cumulative Embryo Score (Steer et al., Hum Reprod 1992;7:117–119) and the total number of embryos produced or transferred.Results: Results are presented in the table. Tabled 1∗p < .01, ∗∗p < 0.005, ∗∗∗p < 0.001Conclusion: As embryos grown in sequential media showed better quality than those produced in HTF, better embryos were available and selected for transfer in the sequential group resulting in higher pregnancy rate. The use of sequential media shows that a stage-specific adjustment to the embryo changing requirements relates to better embryo quality and reproductive performance. Objective: To evaluate the reproductive performance of embryos cultured up to day 3 in an optimized, complex medium (HTF, Irvine, CA) compared with the use of a complex, sequential medium (G1.2 and G2.2, Vitrolife, Sweden). Design: A prospective, randomized comparison between two commercially available culture media. Materials and Methods: Two hundred ninety-four patients (all under 39 y.o. and with day 3 FSH level < 12 mIU/mL) were randomly assigned to HTF or G1.2-G2.2 for fertilization and embryo culture. HTF was supplemented with 5% human serum albumin. Embryos from both groups were cultured in microdroplets under oil in a 5.5% CO2, humidified atmosphere. Groups (HTF vs sequential) were comparable regarding female age (33.3 ± 3.8 vs 33.0 ± 3.3 years old), ovarian stimulation (long protocol with GnRH agonists and rFSH in a step down fashion), estradiol level on the day of the hCG administration (2290.5 ± 1084.4 vs 1911.4 ± 995.0 pg/mL), average number of mature oocytes (9.3 ± 4.4 vs 10.1 ± 5.1), percentage of ICSI procedures performed (50.0 vs 55.3) and average number of transferred embryos (3.6 ± 0.9 vs 3.6 ± 0.7). All transfers were performed on day 3. The average embryo quality was estimated as the ratio between the Cumulative Embryo Score (Steer et al., Hum Reprod 1992;7:117–119) and the total number of embryos produced or transferred. Results: Results are presented in the table. Tabled 1∗p < .01, ∗∗p < 0.005, ∗∗∗p < 0.001 ∗p < .01, ∗∗p < 0.005, ∗∗∗p < 0.001 Conclusion: As embryos grown in sequential media showed better quality than those produced in HTF, better embryos were available and selected for transfer in the sequential group resulting in higher pregnancy rate. The use of sequential media shows that a stage-specific adjustment to the embryo changing requirements relates to better embryo quality and reproductive performance.