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Blastocyst Development in a Single Medium Compared to Sequential Media: A Prospective Study With Sibling Oocytes

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Abstract

The aim of the present study was to compare blastocyst formation rates after embryo culture in a single medium (Global) as compared to sequential media (ISM1/BlastAssist). In this prospective trial with sibling oocytes, 542 metaphase II (MII) oocytes from 31 women were randomly and equally divided to be fertilized and cultured to the blastocyst stage in either sequential media (ISM1/BlastAssist; n = 271 MII oocytes) or a single medium (Global; n = 271 MII oocytes). In both groups, embryos were cultured in an interrupted fashion with media changes on day 3. Embryo transfer was performed on day 5. Blastocyst formation rates on day 5 (61.7% + 19.9% vs 37.0% + 25.5%, P <.001) were significantly higher following culture in Global as compared to ISM1/ BlastAssist, respectively. Fertilization rates, cleavage rates, and percentage of good quality embryos on day 3 were similar between Global and ISM1/BlastAssist, respectively. The percentages of good quality blastocysts (63.0% + 24.8% vs 32.1% + 37.2%, P <.001), blastocysts selected for transfer (27.8% + 19.2% vs 11.1% + 14.4%, P =.005), and utilization rates (62.5% + 24.8% vs 39.0% + 25.2%, P <.001) were significantly higher in Global as compared to ISM1/BlastAssist, respectively. In conclusion, culture in Global was associated with higher blastocyst formation rates compared to ISM1/BlastAssist, suggesting that the single medium may provide better support to the developing embryo.

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References

  1. Gardner DK, Lane M, Schoolcraft WB. Culture and transfer of viable blastocysts: a feasible proposition for human IVF. Hum Reprod. 2000;15(suppl 6):9–23.

    PubMed  Google Scholar 

  2. Gardner D, Schoolcraft W. In vitro culture of the human blasto-cyst. In Jansen R, Mortimer D. ed. Towards Reproductive Certainty: Infertility and Genetics Beyond 1999. 1999:378–388

  3. Biggers JD, Racowsky C. The development of fertilized human ova to the blastocyst stage in KSOM(AA) medium: is a two-step protocol necessary? Reprod Biomed Online. 2002;5(2):133–140.

    PubMed  Google Scholar 

  4. Biggers J, Summers M. Choosing a culture medium: making informed choices. Fertil Steril. 2008;90(3):473–483.

    PubMed  Google Scholar 

  5. Mantikou E, Youssef MAFM, van Wely M, et al. Embryo culture media and IVF/ICSI success rates: a systematic review. Hum Reprod Update. 2013;19(3):210–220.

    CAS  PubMed  Google Scholar 

  6. Machtinger R, Racowsky C. Culture systems: single step. In, Smith GD, Swain JE, Pool TB, eds. Embryo Culture. Vol. 912. New York: Humana Press; 2012:199–209.

    CAS  Google Scholar 

  7. Macklon NS, Pieters MHEC, Hassan MA, Jeucken PHM, Eijke-mans MJC, Fauser BCJM. A prospective randomized comparison of sequential versus monoculture systems for in-vitro human blas-tocyst development. Hum Reprod. 2002;17(10):2700–2705.

    CAS  PubMed  Google Scholar 

  8. Sepulveda S, Garcia J, Arriaga E, Diaz J, Noriega-Portella L, Noriega-Hoces L. In vitro development and pregnancy outcomes for human embryos cultured in either a single medium or in a sequential media system. Fertil Steril. 2009;91(5):1765–1770.

    PubMed  Google Scholar 

  9. Summers MC, Bird S, Mirzai FM, Thornhill A, Biggers JD. Human preimplantation embryo development in vitro: a morphological assessment of sibling zygotes cultured in a single medium or in sequential media. Hum Fertil. 2013;16(4):278–285. doi:10.3109/14647273.2013.806823.

    Google Scholar 

  10. Ciray H, Aksoy T, Goktas C, Ozturk B, Bahceci M. Time-lapse evaluation of human embryo development in single versus sequential culture media—a sibling oocyte study. J. Assist Reprod Genet. 2012;29(9):891–900.

    PubMed  PubMed Central  Google Scholar 

  11. Reed M, Hamic A, Thompson D, Caperton C. Continuous uninterrupted single medium culture without medium renewal versus sequential media culture: a sibling embryo study. Fertil Steril. 2009;92(5):1783–1789.

    PubMed  Google Scholar 

  12. Paternot G, Debrock S, D’Hooghe T, Spiessens C. Early embryo development in a sequential versus single medium: a randomized study. Reprod Biol Endocrinol. 2010;8(1):83.

    PubMed  PubMed Central  Google Scholar 

  13. Wirleitner B, Vanderzwalmen P, Stecher A, Zech MH, Zintz M, Zech NH. Individual demands of human embryo, on IV culture medium: influence on blastocyst development and pregnancy outcome. Reprod Biomed Online. 2010;21(6):776–782.

    CAS  PubMed  Google Scholar 

  14. Hardarson T, Bungum M, Conaghan J, et al. Noninferiority, randomized, controlled trial comparing embryo development using media developed for sequential or undisturbed culture in a time-lapse setup. Fertil Steril. 2015;104(6):1452–1459. e1451-1454.

    PubMed  Google Scholar 

  15. Werner MD, Hong KH, Franasiak JM, et al. Sequential versus Monophasic Media Impact Trial (SuMMIT): a paired randomized controlled trial comparing a sequential media system to a mono-phasic medium. Fertil Steril. 2016;105(5):1215–1221.

    CAS  PubMed  Google Scholar 

  16. Sfontouris IA, Martins WP, Nastri CO, et al. Blastocyst culture using single versus sequential media in clinical IVF: a systematic review and meta-analysis of randomized controlled trials. J Assist Reprod Genet. 2016;33(10):1261–1272.

    PubMed  PubMed Central  Google Scholar 

  17. Lainas TG, Sfontouris IA, Zorzovilis IZ, et al. Flexible GnRH antagonist protocol versus GnRH agonist long protocol in patients with polycystic ovary syndrome treated for IVF: a prospective randomised controlled trial (RCT). Hum Reprod. 2010;25(3):683–689.

    CAS  PubMed  Google Scholar 

  18. Mannaerts B, Van Kuijk J, Griesinger G. Prediction of OHSS in patients treated with Corifollitropin alfa or rFSH in a GnRH antagonist protocol. Hum Reprod. 2012;27(suppl 2):ii26–ii28.

    Google Scholar 

  19. Abdalla HI, Ah-Moye M, Brinsden P, Howe DL, Okonofua F, Craft I. The effect of the dose of human chorionic gonadotropin and the type of gonadotropin stimulation on oocyte recovery rates in an in vitro fertilization program. Fertil Steril. 1987;48(6):958–963.

    CAS  PubMed  Google Scholar 

  20. Kolibianakis EM, Papanikolaou EG, Tournaye H, Camus M, Van Steirteghem AC, Devroey P. Triggering final oocyte maturation using different doses of human chorionic gonadotropin: a randomized pilot study in patients with polycystic ovary syndrome treated with gonadotropin-releasing hormone antagonists and recombinant follicle-stimulating hormone. Fertil Steril. 2007; 88(5):1382–1388.

    CAS  PubMed  Google Scholar 

  21. Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology. The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum Reprod. 2011;26(6):1270–1283.

    Google Scholar 

  22. Gardner DK, Lane M, Stevens J, Schlenker T, Schoolcraft WB. Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer. Fertil Steril. 2000;73(6):1155–1158.

    CAS  PubMed  Google Scholar 

  23. Pomeroy KO, Foley S, Faber BM, Moffitt DV, Johnson MD. A comparison of sequential medium with nonsequential medium: Do some patients’ embryos culture better in one than in the other? Reprod Fertil Dev. 2009;21(1):162–163.

    Google Scholar 

  24. Lawitts JA, Biggers JD. Joint effects of sodium chloride, gluta-mine, and glucose in mouse preimplantation embryo culture media. Mol Reprod Dev. 1992;31(3):189–194.

    CAS  PubMed  Google Scholar 

  25. Anderson AR, Wiemer KE, Weikert ML, Kyslinger ML. Fertilization, embryonic development and pregnancy losses with intra-cytoplasmic sperm injection for surgically-retrieved spermatozoa. Reprod Biomed Online. 2002;5(2):142–147.

    PubMed  Google Scholar 

  26. Wiemer KE, Anderson AR, Kyslinger ML, Weikert ML. Embryonic development and pregnancies following sequential culture in human tubal fluid and a modified simplex optimized medium containing amino acids. Reprod Biomed Online. 2002;5(3):323–327.

    CAS  PubMed  Google Scholar 

  27. Summers MC. A brief history of the development of the KSOM family of media. J Assist Reprod Genet. 2013;30(8):995–999.

    PubMed  PubMed Central  Google Scholar 

  28. Gardner DK, Lane M, Calderon I, Leeton J. Environment of the preimplantation human embryo in vivo: metabolite analysis of oviduct and uterine fluids and metabolism of cumulus cells. Fertil Steril. 1996;65(2):349–353.

    CAS  PubMed  Google Scholar 

  29. Gardner DK, Lane M, Schoolcraft WB. Physiology and culture of the human blastocyst. J Reprod Immunol. 2002;55(1-2):85–100.

    CAS  PubMed  Google Scholar 

  30. Gardner DK, Schoolcraft WB. Culture and transfer of human blastocysts. Curr Opin Obstet Gynecol. 1999;11(3):307–311.

    CAS  PubMed  Google Scholar 

  31. Morbeck DE, Krisher RL, Herrick JR, Baumann NA, Matern D, Moyer T. Composition of commercial media used for human embryo culture. Fertil Steril. 2014;102(3):759–766.e759.

    CAS  PubMed  Google Scholar 

  32. Kleijkers SH, van Montfoort AP, Bekers O. et al. Ammonium accumulation in commercially available embryo culture media and protein supplements during storage at 2-8 degrees C and during incubation at 3, degrees C. Hum Reprod. 2016;31(6):1192–1199.

    CAS  PubMed  Google Scholar 

  33. Schwarzer C, Esteves TC, Arauzo-Bravo MJ, et al. ART culture conditions change the probability of mouse embryo gestation through defined cellular and molecular responses. faHum Reprod. 2012;27(9):2627–2640.

    CAS  Google Scholar 

  34. Xella S, Marsella T, Tagliasacchi D, et al. Embryo quality and implantation rate in two different culture media: ISM1 versu, Universal IV. Medium. Fertil Steril. 2010;93(6):1859–1863.

    PubMed  Google Scholar 

  35. Sfontouris IA, Lainas GT, Sakkas D, Zorzovilis IZ, Petsas GK, Lainas TG. Non-invasive metabolomic analysis using, commercial NIR instrument for embryo selection. J Hum Reprod Sci. 2013;6(2):133–139. doi:10.4103/0974-1208. 117174.

    PubMed  PubMed Central  Google Scholar 

  36. Vergouw CG, Kostelijk EH, Doejaaren E, Hompes PG, Lambalk CB, Schats R. The influence of the type of embryo culture medium on neonatal birthweight after single embryo transfer in IVF. Hum Reprod. 2012;27(9):2619–2626.

    PubMed  Google Scholar 

  37. De Vos A, Janssens R. Van de Velde H, et al. The type of culture medium and the duration of in vitro culture do not influence birthweigh, of AR singletons. Hum Reprod. 2015; 30(1):20–27.

    PubMed  Google Scholar 

  38. Pelinck MJ, Hadders-Algra M, Haadsma ML. et al. Is the birth-weight of singletons bor, after IV reduced by ovarian stimulation of by IV laboratory procedures? Reprod Biomed Online. 2010;21(2):245–251.

    CAS  PubMed  Google Scholar 

  39. Bolton VN, Cutting R, Clarke H, Brison DR. ACE consensus meeting report: culture systems. Hum Fertil (Camb). 2014; 17(4):239–251.

    Google Scholar 

  40. Basile N, Morbeck D, Garcia-Velasco J, Bronet F, Meseguer M. Type of culture media does not affect embryo kinetics: a time-lapse analysis of sibling oocytes. Hum Reprod. 2013;28(3):634–641.

    CAS  PubMed  Google Scholar 

  41. Leese HJ, Conaghan J, Martin KL, Hardy K. Early human embryo metabolism. BioEssays. 1993;15(4):259–264.

    CAS  PubMed  Google Scholar 

  42. Leese HJ. Quiet please, do not disturb: a hypothesis of embryo metabolism and viability. BioEssays. 2002;24(9):845–849.

    PubMed  Google Scholar 

  43. Leese HJ, Sturmey RG, Baumann CG, McEvoy TG. Embryo viability and metabolism: obeying the quiet rules. Hum Reprod. 2007;22(12):3047–3050.

    PubMed  Google Scholar 

  44. Xie Y, Wang F, Puscheck EE, Rappolee DA. Pipetting causes shear stress and elevation of phosphorylated stress-activated protein kinase/jun kinase in preimplantation embryos. Mol Reprod Dev. 2007;74(10):1287–1294.

    CAS  PubMed  Google Scholar 

  45. Sunkara SK, Rittenberg V, Raine-Fenning N, Bhattacharya S, Zamora J, Coomarasamy A. Association between the number of eggs and live birt, in IV treatment: an analysis of 400 135 treatment cycles. Hum Reprod. 2011;26(7):1768–1774.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Eugonia Assisted Reproduction Unit, 7 Ventiri Street, 11528, Athens, Greece

    Ioannis A. Sfontouris PhD, George T. Lainas MD, George K. Petsas PhD & Trifon G. Lainas PhD

  2. Division of Child Health, Obstetrics and Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK

    Ioannis A. Sfontouris PhD

  3. Unit for Human Reproduction, 1st Department of Obstetrics & Gynecology, Papageorgiou General Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Efstratios M. Kolibianakis PhD & Basil C. Tarlatzis PhD

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  1. Ioannis A. Sfontouris PhD
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  2. Efstratios M. Kolibianakis PhD
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  3. George T. Lainas MD
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  5. Basil C. Tarlatzis PhD
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Correspondence to Ioannis A. Sfontouris PhD.

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Sfontouris, I.A., Kolibianakis, E.M., Lainas, G.T. et al. Blastocyst Development in a Single Medium Compared to Sequential Media: A Prospective Study With Sibling Oocytes. Reprod. Sci. 24, 1312–1318 (2017). https://doi.org/10.1177/1933719116687653

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