The influence of the type of embryo culture medium on neonatal birthweight after single embryo transfer in IVF

Vergouw, C.G.; Kostelijk, E.H.; Doejaaren, Els; Hompes, Peter G.A.; Lambalk, Cornelis B.; Schats, R.

doi:10.1093/humrep/des252

Cited by 110 publications

(77 citation statements)

References 33 publications

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“…Earlier efforts to culture human embryos to the blastocyst stage in less sophisticated media resulted in acceptable blastocyst formation rates but very low pregnancy rates [5][6][7][8], indicating that human embryos are capable of developing in diverse culture media, not all of which appear to generate viable embryos with a capacity to implant and result in a pregnancy. The adaptability of human embryos to varying culture conditions has prompted investigation and discussions regarding possible downstream long-term effects of single versus sequential culture on pregnancy outcome and offspring phenotype [43][44][45][46][47].…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, there is some evidence to suggest that the culture environment may affect embryo development, fetal growth, birthweight, and perinatal outcome [47][48][49][50][51][52][53][54][55][56], although the majority of these studies have design shortcomings and/or are limited by sample size. Importantly, follow-up of children born following embryo culture in either single or sequential media was not reported in any of the studies included in the present meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials

Sfontouris

Martins

Nastri

et al. 2016

J Assist Reprod Genet

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Purpose The purpose of this study was to undertake a review of the available evidence comparing the use of a single medium versus sequential media for embryo culture to the blastocyst stage in clinical IVF. Methods We searched the Cochrane Central, PubMed, Scopus, ClinicalTrials.gov, Current Controlled Trials and WHO International Clinical Trials Registry Platform to identify randomized controlled trials comparing single versus sequential media for blastocyst culture and ongoing pregnancy rate. Included studies randomized either oocytes/zygotes or women. Eligible oocyte/zygote studies were analyzed to assess the risk difference (RD) and 95 % confidence intervals (CI) between the two media systems; eligible woman-based studies were analyzed to assess the risk ratio (RR) and 95 % CI for clinical pregnancy rate. Results No differences were observed between single and sequential media for either ongoing pregnancy per randomized woman (relative risk (RR) = 0.9, 95 % CI = 0.7 to 1.3, two studies including 246 women, I 2 = 0 %) or clinical pregnancy per randomized woman (RR = 1.0, 95 % CI = 0.7 to 1.4, one study including 100 women); or miscarriage per clinical pregnancy: RR = 1.3, 95 % CI = 0.4 to 4.3, two studies including 246 participants, I 2 = 0 %). Single media use was associated with an increase blastocyst formation per randomized oocyte/ zygote (relative distribution (RD) = +0.06, 95 % CI = +0.01 to Declaration of Authors' Roles Conception and design (CR, LR, WPM, IAS, and NR-F); search strategy (WPM, IAS); data extraction (WPM, PAN, IGRV, CON), analysis, and interpretation (all authors); writing the article (all authors). All authors had full access to all the data in the study and approved the final manuscript.Capsule In conclusion, there is insufficient evidence to recommend either sequential or single-step media as being superior for the culture of embryos to days 5/6 blastocyst stage. +0.12, ten studies including 7455 oocytes/zygotes, I 2 = 83 %) but not top/high blastocyst formation (RD = +0.05, 95 % CI = −0.01 to +0.11, five studies including 3879 oocytes/zygotes, I 2 = 93 %). The overall quality of the evidence was very low for all these four outcomes. Electronic supplementary materialConclusions Although using a single medium for extended culture has some practical advantages and blastocyst formation rates appear to be higher, there is insufficient evidence to recommend either sequential or single-step media as being superior for the culture of embryos to days 5/6. Future studies comparing these two media systems in well-designed trials should be performed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials

Sfontouris

Martins

Nastri

et al. 2016

J Assist Reprod Genet

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“…The majority of the changes described affect imprinted genes, which have been involved mainly with fetal and placental growth. [25][26][27] However, it has been suggested that methylation might be relevant for other functions not yet characterized. 26 The importance of DNA methylation in the regulation of vascular endothelial function is being increasingly demonstrated, including nitric oxide expression and synthesis and endothelial angiogenesis.…”

Section: Discussionmentioning

confidence: 99%

Assisted Reproductive Technologies Are Associated With Cardiovascular Remodeling In Utero That Persists Postnatally

et al. 2013

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A ssisted reproductive technologies (ARTs), mainly standard in vitro fertilization or intracytoplasmic sperm injection, permit childbirth in many infertile couples and nowadays represent 1% to 4% of births in developed countries.1 Although these technologies are generally considered safe, the potential association of ART with poorer pregnancy outcomes has long been investigated. There is evidence that ART is associated with increased risk for adverse perinatal outcome and congenital malformations.2 This notwithstanding, it is not possible to separate ART-related risks from those secondary to the underlying reproductive pathology of the infertile couple. [3][4][5] In this scenario, preliminary evidence has recently suggested that ART could be associated with long-term cardiovascular changes. Ceelen et al 6 first suggested the presence of increased blood pressure in late childhood after ART conception. More recently, another study demonstrated the presence of signs of systemic and pulmonary vascular dysfunction in 12-year-old children conceived by ART. Editorial see p 1398 Clinical Perspective on p 1450Background-Assisted reproductive technologies (ARTs) have been shown to be associated with general vascular dysfunction in late childhood. However, it is unknown whether cardiac remodeling is also present and if these changes already manifest in prenatal life. Our aim was to assess fetal and infant (6 months of age) cardiovascular function in ART pregnancies. Methods and Results-This prospective cohort study included 100 fetuses conceived by ART and 100 control pregnancies.ART fetuses showed signs of cardiovascular remodeling, including a more globular heart with thicker myocardial walls, decreased longitudinal function (tricuspid ring displacement in controls: median, 6.

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“…These findings have been confirmed in a subsequent study by the same group [45]. In contrast, other investigators failed to detect any difference in birth weights in a retrospective study comparing embryos cultured in human tubal fluid with added human serum albumin to Sage Ò Quinn's advantage protein plus medium [46].…”

Section: Risks Associated With the Culture Of Gametes And Embryosmentioning

confidence: 72%

What are the risks of the assisted reproductive technologies (ART) and how can they be minimized?

Rebar

2013

Reprod Medicine & Biology

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Although assisted reproductive technologies (ART) have become established procedures performed around the world, there are still many unanswered questions regarding safety. Possible risks associated with infertility and ART include (1) those inherent to pregnancy, delivery, and childhood; (2) those associated with the infertility itself and its causes; and (3) risks iatrogenic to ART. Although there are many potential risks associated with ART, it has become clear that the major risk is multiple pregnancy and its consequences. Major efforts are warranted to reduce the risk of multiple gestations with IVF, but it is also clear that single-embryo transfer is not the solution in all cases. Moreover, several studies have now documented that perinatal outcomes are somewhat poorer in IVF singleton infants than in spontaneously conceived singletons, but it is not clear if this increased risk is due to the ART or the infertility. Concerns about the impact of abnormalities in genomic imprinting persist at this time, as do risks associated with the culture conditions and even our environment. Only time will tell if children born following ART are at any increased risk of developing certain chronic diseases as they age. In any case, the risks to IVF children and mothers are likely to remain higher than those for children and mothers conceived spontaneously without medical assistance. However, since there have been over 5 million births after ART worldwide, and the vast majority of pregnancies and children have been essentially ''normal'', it is obvious that any excess risk must be relatively small. The normality of most pregnancies mandates that extreme care be exercised in making any changes to current practice.

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The influence of the type of embryo culture medium on neonatal birthweight after single embryo transfer in IVF

Cited by 110 publications

References 33 publications

Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials

Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials

Assisted Reproductive Technologies Are Associated With Cardiovascular Remodeling In Utero That Persists Postnatally

What are the risks of the assisted reproductive technologies (ART) and how can they be minimized?

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