Prospective Trial of 4 Differents Culture Media on Fertilization and Cleavage Rate

Objectives: Culture media play a fundamental role in IVF\ICSI procedures, but debate is still on-going among the best culture media for 2\3 days embryo culture. Aim of this study was to evaluate the impact of different culture media in order to understand if differences might be noticed in fertilizing and cleavage rate during an IVF/ICSI program. Design: Prospective study of 7 months, covering 196 IVF/ICSI consecutives cycles after superovulation induction with homogeneous stimulation protocols (GnRH analog long protocol + Recombinant FSH) and a unified culture protocol. Materials and Methods: We tested randomly four different culture media: HTF, IVF 50, MENEZO B2 and MEDI CULT IVF. These media are previously tested for osmolarity, PH and fertilization rate of hampster eggs. In all cases we followed the same culture standardized routinely in dishes. Media are prepared before oocyte retrieval and equilibrated overnight (37°C, 5% CO2). The in vitro maturation dishes contain seven drops of media, one egg for drop, overlaid with about 1.5 ml. of equilibrated paraffin oil. The choice of medium was randomized. 2465 oocytes have been retrieved in 196 cycles and 1573 of them were inseminated/injected. The mean value of inseminated eggs per patient was 8.9 with HTF; 8.3 with IVF 50; 7.8 with MEDI CULT IVF and 7.1 with MENEZO B2. Comparison of embryos showed that 737 on 852 were of good quality (grade I-II), parameter determined according to the morphology: grade I (intact, equal symmetric blastomeres), grade II (a few fragments in the perivitelline space). Results: Tabled 1MediumTotal cases (%)Inseminated eggs (%)HTF50 (25.5%)28.2% (445\1573)IVF 5058 (29.5%)30.6% (482\1573)MEDI CULT IVF28 (14.3%)14.0% (220\1573)MENEZO B260 (30.7%)27.1% (426\1573) Open table in a new tab legendFertilization ratelegendNo significant difference has been noticed among the four culture media groups. Fertilization rate, cleavage rate and embryo quality (MANOVA p<0.75 Statsoft 1997) of the inseminated/injected eggs gave comparable results.Cleavage rate(%) Grade I-II49.8% (222\445)48.3% (215\445)86% (184\215)56.3% (274\482)54.9% (265\482)91% (241\265)57.7% (127\220)56.3% (124\220)81% (101\124)59.6% (254\426)58.2% (248\426)85% (211\248)legend No significant difference has been noticed among the four culture media groups. Fertilization rate, cleavage rate and embryo quality (MANOVA p<0.75 Statsoft 1997) of the inseminated/injected eggs gave comparable results. Open table in a new tab Conclusions: Preliminary results of our prospective study shows that different culture media have no impact on fertilization and cleavage rate. The data collection is in progress to reach a number of cases with statistical power to evaluate if any difference can be found in the implantation rate, indicating if a specific culture media can affect embryo viability after IVF/ICSI. These first results suggest that if a standardized procedure is employed, data from differents PMA Centers could be compared independently from the culture medium used.