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ABSTRACT: 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 +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.Conclusions
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.
SUBMITTER: Sfontouris IA
PROVIDER: S-EPMC5065552 | biostudies-literature | 2016 Oct
REPOSITORIES: biostudies-literature
Sfontouris Ioannis A IA Martins Wellington P WP Nastri Carolina O CO Viana Iara G R IG Navarro Paula A PA Raine-Fenning Nick N van der Poel Sheryl S Rienzi Laura L Racowsky Catherine C
Journal of assisted reproduction and genetics 20160805 10
<h4>Purpose</h4>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.<h4>Methods</h4>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 p ...[more]