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Does the Human Embryo Culture Media has any Impact on Implantation and Live Birth Rate in Art Cycles? A Comparative Study

Sreesha Viswam, A. David Ravindran, Sujatha Ramakrishnan, Alex C. Varghese, C. Mohammed Ashraf


Introduction: Culture media plays a pivotal role in embryo culture system apart from the other crucial components as air quality, temperature, humidity etc., so that the selection of embryo culture media is a crucial step for the embryology team for the optimal blastocyst development and for achieving aviable pregnancy.There are two opposing views for the selection of embryo culture medium. One is embryo free choice’- “Let the embryo choose” (single step media) and the other one is ‟back to nature” (sequential media) approach. Present study analyses the efficacy of these media in terms of embryo developments in vitro and pregnancy rates. Materials and Methods: Patients were randomly recruited for single step or sequential media culture post intra cytoplasmic sperm injection (ICSI). Inclusion criteria were patients with no severe male or female factors. To minimise the confounding variables, patients with surgically retrieved sperm samples were excluded from the study. Biochemical pregnancy, clinical pregnancy, implantation rate, live birth rate rate and miscarriage rate were analysed. Results: Biochemical pregnancy, clinical pregnancy and live birth rate were favourable for group 2 (sequential media) but not statistically significant. None of the analysed parameters differed significantly among the two media. Conclusion: There is a lack of a solid scientific data to support sequential media culture.However, moving embryos from one medium to another in sequential media system probably adds significant stress to the pre-implantation developing embryos in-culture apart from the unintentional humane errors. Moreover, this approach is quite labor intensive and expensive.


Embryo culture, single step media, sequential media, implantation, IVF, pregnancy.

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