Embryo culture media and IVF/ICSI success rates: a systematic review

Abstract

BACKGROUND The media that are used to culture human preimplantation embryos are considered to be an important factor for the success rates of IVF/ICSI. Here, we present a systematic review of randomized controlled trials (RCTs) on the effect of culture media on IVF/ICSI success rates. METHODS RCTs published between January 1985 and July 2012 were eligible for inclusion. The primary outcome was live birth. Secondary outcomes were health of babies born, ongoing pregnancies, clinical pregnancies, miscarriages, multiple pregnancies, implantation rate, cryopreservation rate, embryo quality and fertilization rate. For those media that were evaluated in more than one comparison, an unconventional meta-analysis was performed by pooling the data of the media they were compared to. RESULTS Twenty-two RCTs were included that evaluated 31 different comparisons. Conventional meta-analysis was not possible for any of the outcomes as nearly all trials compared different culture media. Only four trials reported on live birth, and one of them reported a significant difference. Nine trials reported on ongoing and/or clinical pregnancy rates, of which four showed a significant difference. Pooling the data did not reveal a superior culture medium. CONCLUSIONS It is yet unknown what culture medium leads to the best success rates in IVF/ICSI. Given the potential importance of culture media for treatment outcome, rigorously designed RCTs are needed for currently available, as well as newly introduced culture media.

Effects of granulocyte-macrophage colony-stimulating factor supplementation in culture medium on embryo quality and pregnancy outcome of women aged over 35 years

“…Culture conditions are important for the outcome of assisted reproductive technologies and have an impact on pre-and postimplantation development and possibly the future health of the offspring [1,[5][6][7][8]. An inappropriate culture can lead to impaired embryo development and even recurrent implantation failure [1,9,10].…”

Reduced blastocyst formation in reduced culture volume

“…Regarding the embryo culture studies performed on human embryos, it is difficult to compare our results with older studies using more basic culture media under high oxygen [22,14]); especially since it is known that the current culture media are highly enriched and that the use of low oxygen concentration is now consensual for all mammalian embryo culture systems [18]. Most data on culture media derives from studies comparing two different media and these results have been well summarized by Mantikou et al [9]. However, little information is available on studies in which one culture medium is used in different setups (grouped culture or not, different culture volumes).…”

A prospective randomized study comparing two commercially available types of human embryo culture media: G1-PLUSTM/G2-PLUSTM sequential medium (Vitrolife) and the GL BLASTTM sole medium (Ingamed)

“…We did not observe any statistical difference in relation to the comparison of overall pregnancy rates. Mantikou et al, 2013, in his systematic review, evaluated 20 different methods of cultivation from 11 different companies and concluded that it is still uncertain as to which is the best medium to cultivate embryos to improve pregnancy rates for in vitro fertilization. As observed in the previously mentioned studies, there remains uncertainty as to which culture medium facilitates the highest pregnancy rate.…”