Reduced oxygen tension improves embryo quality but not clinical pregnancy rates: a randomized clinical study into ovum donation cycles.

OBJECTIVE: To investigate the effect of low O2 tension during in vitro culture in terms of ongoing pregnancy rates in ovum donation cycles. DESIGN: Randomized trial. SETTING: Private university-affiliated IVF center, university-based hospital. PATIENT(S): A total of 1,125 cycles of ovum donation. INTERVENTION(S): Embryo culture in an atmosphere of 5.5% CO2, 6% O2, and 88.5% N2 versus a dual-gas system of 5.5% CO2 in air. MAIN OUTCOME MEASURE(S): Ongoing clinical pregnancy rates per intention-to-treat (ITT) patients. RESULT(S): The use of low O2 tension achieved a 41.3% ongoing pregnancy rate per ITT compared with a 40.8% rate obtained for 5% CO2 in air. The mean number of blastomeres and the percentage of top-quality embryos were significantly higher after lower O2 concentration during in vitro culture (7.1 ± 3.6 and 28.6% vs. 7.3 ± 8.4 and 32.1%, respectively). CONCLUSION(S): In the ovum donation cycles undergoing day-3 embryo transfers, the use of low O2 tension did not improve ongoing pregnancy rates per cycle and per transfer. However, it benefited embryo quality, demonstrating the potential negative impact of high O2 tension on the in vitro embryo development.

Storage of human oocytes in the vapor phase of nitrogen.

OBJECTIVE: To evaluate the effectiveness of long-term vapor-phase nitrogen storage of vitrified human oocytes as a strategy for preventing the risk of cross-contamination due to direct contact with the liquid nitrogen (LN). DESIGN: Prospective randomized study. SETTING: Private infertility center, IVI, Valencia. PATIENT(S): Oocyte donors (n = 44) and recipients (n = 46). INTERVENTION(S): Vitrification by the Cryotop method. Storage of vitrified oocytes in a vapor-phase nitrogen storage freezer and a traditional LN storage tank. Donation of the surviving oocytes and evaluation of fertilization, embryo development, and clinical results. MAIN OUTCOME MEASURE(S): Survival, fertilization, and cleavage rates. Embryo quality and clinical outcome. RESULT(S): Survival was 95.3% (vapor-phase nitrogen) and 94.5% (LN). Fertilization rates (73.1% and 71.7%) or cleavage on day 2 (95.6% and 94.7%), day 3 (84.5% and 79.9%), and blastocyst formation (54.7% and 53.9%) were similar between vapor-phase nitrogen and LN. Implantation, clinical, and ongoing pregnancy rates were similar for vapor-phase nitrogen (40.5%, 58.1%, and 48.8%, respectively) and LN groups (33.7%, 53.3%, and 46.6%, respectively). CONCLUSION(S): The vapor-phase nitrogen system permits the storage of oocytes vitrified, maintaining their potential to develop into competent embryos in a similar manner as those stored in a traditional LN freezer. This approach represents a practical alternative that prevents cross-contamination during the storage of vitrified samples.