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Ruíz M, Santamaría-López E, Blasco V, Hernáez MJ, Caligara C, Pellicer A, Fernández-Sánchez M, Prados N. Effect of Group Embryo Culture under Low-Oxygen Tension in Benchtop Incubators on Human Embryo Culture: Prospective, Randomized, Controlled Trial. Reprod Sci 2020; 27:1522-1533. [PMID: 31994003 DOI: 10.1007/s43032-020-00150-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 12/30/2019] [Indexed: 10/25/2022]
Abstract
To evaluate the efficacy of group embryo culture under low-oxygen tension in benchtop incubators on human embryo development in vitro. The study was designed as a prospective, patient blind, randomized, controlled trial of a complex intervention. One hundred forty-eight women undergoing IVF were recruited in our fertility practice and randomized into two groups: intervention group (study culture strategy) or control group (control culture strategy). Intervention group embryos were cultured grouped under low-oxygen tension in benchtop incubators while control group embryos were cultured individually under atmospheric oxygen tension in large-box incubators. Using the study culture strategy, there were a significantly higher implantation rate (65.1% vs 49.2%; RR, 1.42; 95% CI, 1.17-1.73) and live birth delivery rate per embryo transfer (52.7% vs 39.5%; RR, 1.33; 95% CI, 1.02-1.75) with the first fresh embryo transfer. Cumulative implantation rate (56.7% vs 43.6%; RR, 1.30; 95% CI, 1.05-1.62) and cumulative live birth rate per embryo transfer (47.4% vs 36.2%; RR, 1.31; 95% CI, 1.01-1.69) were also statistically significantly increased in the study culture strategy. Human embryos exposed to our study culture condition strategy had statistically significant increased cumulative implantation rate and cumulative live birth rate per embryo transferred. Our findings suggest that this strategy specially favours poor quality embryos. Clinical Trial Registration Number: NCT01904006.
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Affiliation(s)
- Myriam Ruíz
- IVI-RMA Seville, Avda. República Argentina 58, ES-41011, Seville, Spain.,IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), ES-46026, Valencia, Spain
| | - Esther Santamaría-López
- IVI-RMA Seville, Avda. República Argentina 58, ES-41011, Seville, Spain.,IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), ES-46026, Valencia, Spain
| | - Víctor Blasco
- IVI-RMA Seville, Avda. República Argentina 58, ES-41011, Seville, Spain.,IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), ES-46026, Valencia, Spain
| | - María José Hernáez
- IVI-RMA Seville, Avda. República Argentina 58, ES-41011, Seville, Spain.,IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), ES-46026, Valencia, Spain
| | - Cinzia Caligara
- IVI-RMA Seville, Avda. República Argentina 58, ES-41011, Seville, Spain.,IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), ES-46026, Valencia, Spain
| | - Antonio Pellicer
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), ES-46026, Valencia, Spain.,Department of Pediatrics, Obstetrics and Gynecology, School of Medicine, Valencia University, ES-46010, Valencia, Spain.,IVI-RMA Rome, Largo Ildebrando Pizzetti 1, IT-00197, Rome, Italy
| | - Manuel Fernández-Sánchez
- IVI-RMA Seville, Avda. República Argentina 58, ES-41011, Seville, Spain. .,IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), ES-46026, Valencia, Spain. .,Departamento de Cirugía, Universidad de Sevilla, Avda. Sánchez Pizjuan S/N, ES-41009, Seville, Spain. .,Departamento de Biología Molecular e Ingeniería Bioquímica, Universidad Pablo de Olavide, ES-41013, Seville, Spain.
| | - Nicolás Prados
- IVI-RMA Seville, Avda. República Argentina 58, ES-41011, Seville, Spain.,IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), ES-46026, Valencia, Spain.,Departamento de Biología Molecular e Ingeniería Bioquímica, Universidad Pablo de Olavide, ES-41013, Seville, Spain
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Kelley RL, Gardner DK. Combined effects of individual culture and atmospheric oxygen on preimplantation mouse embryos in vitro. Reprod Biomed Online 2016; 33:537-549. [PMID: 27569702 DOI: 10.1016/j.rbmo.2016.08.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 08/08/2016] [Accepted: 08/09/2016] [Indexed: 10/21/2022]
Abstract
Embryos are routinely cultured individually, although this can reduce blastocyst development. Culture in atmospheric (20%) oxygen is also common, despite multiple detrimental effects on embryos. Although frequently occurring together, the consequences of this combination are unknown. Mouse embryos were cultured individually or grouped, under physiological (5%) or atmospheric (20%) oxygen. Embryos were assessed by time-lapse and blastocyst cell allocation. Compared with the control group (5% oxygen group culture), 5-cell cleavage (t5) was delayed in 5% oxygen individual culture and 20% oxygen group culture (59.91 ± 0.23, 60.70 ± 0.29, 63.06 ± 0.32 h post-HCG respectively, P < 0.05). Embryos in 20% oxygen individual culture were delayed earlier (3-cell cleavage), and at t5 cleaved later than embryos in other treatments (66.01 ± 0.40 h, P < 0.001), this delay persisting to blastocyst hatching. Compared with controls, hatching rate and cells per blastocyst were reduced in 5% oxygen single culture and 20% oxygen group culture (134.1 ± 3.4, 104.5 ± 3.2, 73.4 ± 2.2 cells, P < 0.001), and were further reduced in 20% oxygen individual culture (57.0 ± 2.8 cells, P < 0.001), as was percentage inner cell mass. These data indicate combining individual culture and 20% oxygen is detrimental to embryo development.
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Affiliation(s)
- Rebecca L Kelley
- School of BioSciences, The University of Melbourne, Parkville, Victoria 3010, Australia.
| | - David K Gardner
- School of BioSciences, The University of Melbourne, Parkville, Victoria 3010, Australia.
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