Study Results
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Basic Information
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UNKNOWN
50 participants
OBSERVATIONAL
2021-07-15
2023-12-31
Brief Summary
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Culture conditions are very important for the success of the IVF cycle, many of the factors involved in the process have been extensively studied, including the use of sequential culture medium vs single step culture medium, humidified incubators vs dry incubators and refreshing the medium on day 3 vs uninterrupted culture till day 5. However, none of the studies investigated the effect on euploid rate in a sibling oocyte design with PGT-A, which requires culture till day 7.
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Detailed Description
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To reduce the rate of evaporation, culture droplets are covered with a layer of mineral oil. Humidified incubators can also reduce the rate of evaporation. However, in the case of dry incubators, such as benchtop incubators, replenishing the culture medium at least once -by moving the embryos to a new culture dish- during these 7 days of culture might be the solution.
Since single-step medium is designed to sustain embryo development for 5 continuous culture days, while some laboratories culture embryos for 7 days, refreshing the culture medium is inevitable either on day 3 or day 5 of development.
There is no concrete evidence on which of these practices will provide a better environment for embryo development. Moreover, none of the studies investigated the effect of single-step culture medium changeover on day 3 or day 5, on the chromosomal errors (aneuploidy/mosaicism). Investigators aim in this prospective sibling oocyte study, to explore which day of culture medium refreshment (day 3 or day 5) provides a higher rate of euploid blastocysts.
Conditions
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Study Design
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COHORT
RETROSPECTIVE
Study Groups
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day 3 refreshment
All MII oocytes will be inseminated by ICSI 39-41 hours post final oocyte maturation trigger.
Following ICSI, oocytes will be cultured in 2-4 culture dishes placed in 2 separate chambers.
Media refreshment: Zygote scoring on day 1 (18-20hpi). Culture medium refreshment will be done 67-69 hours post insemination (Day3). Embryo grading will not be done day2-5. Culture media preparation and refreshment: 30µL of culture medium (Global total LP is added to each well of the 8 wells of LifeGlobal GPS Dish (EGPS-010) and 50µL to the center 3 drops.
Dishes will be equilibrated overnight in a CO2 incubator. Embryo grading should be done prior to media refreshment. Time out of the incubator during media refreshment will be assessed on day 3 and day 5.
One operator should perform the ICSI. In case of multiple operators, each operator's injected oocytes will be split between the 2 groups.
Insemination and culture
All MII oocytes will be inseminated by ICSI 39-41 hours post final oocyte maturation trigger.
Media refreshment Group 1
Zygote scoring on day 1 (18-20hpi). Culture medium refreshment will be done 67-69 hours post insemination (Day3).
Culture media preparation and refreshment
30µL of culture medium (Global total LP is added to each well of the 8 wells of LifeGlobal GPS Dish (EGPS-010) and 50µL to the center 3 drops.
Dishes will be equilibrated overnight in a CO2 incubator.
Embryo grading
Should be done prior to media refreshment. For group 2, embryo grading and media refreshment is done prior to blastocyst biopsy.
day 5 refreshment
All MII oocytes will be inseminated by ICSI 39-41 hours post final oocyte maturation trigger.
Following ICSI, oocytes will be cultured in 2-4 culture dishes placed in 2 separate chambers.
Media refreshment and embryo grading timings: Zygote scoring on day 1 (18-20hpi). Embryo grading and culture media refreshment will be done 114-118 hours post insemination (Day5).
Culture media preparation and refreshment: 30µL of culture medium (Global total LP is added to each well of the 8 wells of LifeGlobal GPS Dish (EGPS-010) and 50µL to the center 3 drops. Dishes will be equilibrated overnight in a CO2 incubator.
Embryo grading and media refreshment is done prior to blastocyst biopsy. Time out of the incubator during media refreshment will be assessed on day 3 and day 5.
One operator should perform the ICSI. In case of multiple operators, each operator's injected oocytes will be split between the 2 groups.
Insemination and culture
All MII oocytes will be inseminated by ICSI 39-41 hours post final oocyte maturation trigger.
Culture media preparation and refreshment
30µL of culture medium (Global total LP is added to each well of the 8 wells of LifeGlobal GPS Dish (EGPS-010) and 50µL to the center 3 drops.
Dishes will be equilibrated overnight in a CO2 incubator.
Embryo grading
Should be done prior to media refreshment. For group 2, embryo grading and media refreshment is done prior to blastocyst biopsy.
Media refreshment Group 2
Zygote scoring on day 1 (18-20hpi). Culture media refreshment will be done 114-118 hours post insemination (Day5).
Interventions
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Insemination and culture
All MII oocytes will be inseminated by ICSI 39-41 hours post final oocyte maturation trigger.
Media refreshment Group 1
Zygote scoring on day 1 (18-20hpi). Culture medium refreshment will be done 67-69 hours post insemination (Day3).
Culture media preparation and refreshment
30µL of culture medium (Global total LP is added to each well of the 8 wells of LifeGlobal GPS Dish (EGPS-010) and 50µL to the center 3 drops.
Dishes will be equilibrated overnight in a CO2 incubator.
Embryo grading
Should be done prior to media refreshment. For group 2, embryo grading and media refreshment is done prior to blastocyst biopsy.
Media refreshment Group 2
Zygote scoring on day 1 (18-20hpi). Culture media refreshment will be done 114-118 hours post insemination (Day5).
Eligibility Criteria
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Inclusion Criteria
* Patients with a minimum of 8 mature oocytes
* PGT-A
* ICSI
* BMI\<35
* Age 18- 40
* Fresh or frozen ejaculated sperm \>10,000 motile sperm
* Any ovarian stimulation
* Embryos cultured in benchtop incubator
Exclusion Criteria
* Previous history of embryo arrest
* Endometriosis
* History of previous treatment which may impact the ovarian reserve (adnexal surgery, chemotherapy, radiation…)
18 Years
40 Years
FEMALE
Yes
Sponsors
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ART Fertility Clinics LLC
OTHER
Responsible Party
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Ibrahim Elkhatib
Principal Investigator
Principal Investigators
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IBRAHIM ELKHATIB
Role: PRINCIPAL_INVESTIGATOR
ART Fertility Clinics LLC
Locations
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ART Fertility Clinics LLC
Abu Dhabi, , United Arab Emirates
Countries
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Central Contacts
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Facility Contacts
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References
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Bavister BD, Poole KA. Duration and temperature of culture medium equilibration affect frequency of blastocyst development. Reprod Biomed Online. 2005 Jan;10(1):124-9. doi: 10.1016/s1472-6483(10)60813-9.
Costa-Borges N, Belles M, Meseguer M, Galliano D, Ballesteros A, Calderon G. Blastocyst development in single medium with or without renewal on day 3: a prospective cohort study on sibling donor oocytes in a time-lapse incubator. Fertil Steril. 2016 Mar;105(3):707-713. doi: 10.1016/j.fertnstert.2015.11.038. Epub 2015 Dec 12.
Pena F, Davalos R, Rechkemmer A, Ascenzo A, Gonzales M. Embryo development until blastocyst stage with and without renewal of single medium on day 3. JBRA Assist Reprod. 2018 Mar 1;22(1):49-51. doi: 10.5935/1518-0557.20180012.
Krasnopolskaya KV, Beketova AN, Sesina NI, capital ES, Cyrillichinchenko NK, Badalyan GV, Sudarikova NM, Bocharova TV, Zakharchenko EO. The effect of short-term disturbance of day 3 embryo culture on the development and implantation. Gynecol Endocrinol. 2019;35(sup1):1-4. doi: 10.1080/09513590.2019.1632083.
Related Links
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1\. Mori, C., Kuwayama, M., Silber, S., Kagawa, N., Kato, H. Water evaporation and osmolality change of human embryo culture media in humid or in dry culture systems. Fertil. Steril. 2010; 94: s151
Other Identifiers
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2105-ABU-008-IK
Identifier Type: -
Identifier Source: org_study_id
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