The influence of the type of embryo culture media on the outcome of IVF/ICSI cycles.

OBJECTIVE: Embryo culture media are important factors in IVF, which can significantly influence clinical outcome of IVF/ICSI cycles. Despite this, it is still not completely clear which formulation is most optimal and whether sequential or continuous media should be favored. MATERIALS AND METHODS: This study retrospectively analyzed the outcome of IVF/ICSI cycles with regard to different types of culture media used to culture embryos, namely sequential and two types of single step continuous embryo culture media. RESULTS: If the data were combined for both types of single step continuous embryo culture media the only significant difference we observed was the proportion of poor quality embryos on day 3, which was significantly higher (16.9% vs. 22.5%; P = 0.017) in the sequential media. The pregnancy (55.1% vs. 40.5%; P = 0.113) and live birth rates (42.9% vs. 33.8%; P = 0.308) were lower in continuous media, although the difference was not statistically significant. Furthermore, the blastocyst rate (sequential vs. continuous; 47.4% vs. 47.3%; P = 1), and birthweight (3280 ± 630g vs. 3272 ± 575g; P = 0.96) did not significantly differ regardless of the medium used to culture embryos. Additional comparison of each type of continuous medium to sequential media revealed that the difference in the quality of cleavage stage embryos for combined data of both continuous culture media may be derived from the group of cycles were SAGE 1-Step was used to culture embryos. CONCLUSION: These results therefore indicate that continuous media can be equivalent to sequential media and could help lower the workload in busy IVF labs without impairing the clinical results. Although, caution is needed because this study is limited by its retrospective design. To confirm the results, especially in terms of live birth rates and perinatal outcome, a prospective study is needed with a higher number of included couples.

Successful freezing and thawing of blastocysts cultured in sequential media using a modified method.

OBJECTIVE: To evaluate the clinical role of blastocyst freezing and thawing after prolonged culturing in sequential media. DESIGN: Retrospective analysis of 293 blastocyst freeze-thawing cycles. SETTING: University hospital infertility unit. PATIENT(S): Nonselected couples undergoing IVF. INTERVENTION(S): Blastocysts were frozen and thawed by a modified method. MAIN OUTCOME MEASURES: Blastocyst recovery after freeze-thawing and pregnancy rates after the transfer. Evaluation of the effect of the number of transferred blastocysts, the method of IVF, and of the woman's age on the results achieved by frozen-thawed blastocysts. RESULT(S): Frozen-thawed blastocysts provided a 29.5% clinical pregnancy rate per transfer. After the transfer of three blastocysts the pregnancy rate was 42.0%, and after the transfer of one or two blastocysts it was approximately the same (25.0% and 28.0%, respectively). The method of IVF did not affect pregnancy rates, but the increasing age of the woman did. Pregnancies were characterized by a low abortion rate (8.0%) regardless of the age of the woman. CONCLUSION(S): A modified method for blastocyst freeze-thawing provides good clinical results. It offers the possibility for a single-thawed blastocyst transfer and represents a good alternative for older women because of its lower risk of spontaneous abortion.