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Journal of Assisted Reproduction and Genetics

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01-07-2018 | Assisted Reproduction Technologies

Continuous embryo culture elicits higher blastulation but similar cumulative delivery rates than sequential: a large prospective study

Authors: Danilo Cimadomo, C. Scarica, R. Maggiulli, G. Orlando, D. Soscia, L. Albricci, S. Romano, F. Sanges, F. M. Ubaldi, L. Rienzi

Published in: Journal of Assisted Reproduction and Genetics | Issue 7/2018

Abstract

Purpose

To assess whether continuous embryo culture involves better embryological and/or clinical outcomes than sequential.

Methods

Prospective study at a private IVF center. All consecutive IVF cycles (September 2013–2015) fulfilling the inclusion criteria underwent embryo culture in either Continuous-Single-Culture-Media (CSCM, n = 972) or sequential media (Quinn’s Advantage, n = 514), respectively. ICSI, blastocyst culture in either standard (MINC) or undisturbed (Embryoscope) incubation, transfer (until September 2016), and pregnancy follow-up (until September 2017) were performed. When aneuploidy testing was required, trophectoderm biopsy and qPCR were performed. Sub-analyses and logistic regression corrected for confounders were performed. The primary outcomes were overall blastocyst rate per oocyte and mean blastocyst rate per cycle. The sample size was defined to reach 95 and 80% statistical power for the former and the latter outcome, respectively. Secondary outcomes were euploidy (if assessed), cumulative delivery rates, gestational age, and birthweight.

Results

Continuous embryo culture resulted into a higher overall blastocyst rate per inseminated oocyte than sequential (n = 2211/5841, 37.9% vs. 1073/3216, 33.4%; p < 0.01), confirmed also from a cycle-based analysis (mean blastocyst rate: 38.7% ± 29.7% vs. 34.3% ± 29.4%; p = 0.01). The continuous media (OR = 1.23), the undisturbed incubation system (OR = 1.22), the maternal age (OR = 0.92), and the sperm factor (OR = 0.85) were outlined as positive predictors of blastulation. However, the cumulative delivery rates per ended cycle (i.e., delivery achieved or no blastocyst produced or left; > 90%) were comparable in the two groups (n = 244/903, 27.0% vs. 129/475, 27.2%). The neonatal outcomes were similar.

Conclusions

Continuous culture involves better embryological but similar clinical outcomes than sequential. This large prospective study supports the absence of clinical disparity among the two approaches.

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Title: Continuous embryo culture elicits higher blastulation but similar cumulative delivery rates than sequential: a large prospective study
Authors: Danilo Cimadomo
C. Scarica
R. Maggiulli
G. Orlando
D. Soscia
L. Albricci
S. Romano
F. Sanges
F. M. Ubaldi
L. Rienzi
Publication date: 01-07-2018
Publisher: Springer US
Published in: Journal of Assisted Reproduction and Genetics / Issue 7/2018
Print ISSN: 1058-0468
Electronic ISSN: 1573-7330
DOI: https://doi.org/10.1007/s10815-018-1195-4

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Springer Medicine

Continuous embryo culture elicits higher blastulation but similar cumulative delivery rates than sequential: a large prospective study

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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