Integrating insulin into single-step culture medium regulates human embryo development in vitro

Fertil Steril. 2017 Feb;107(2):405-412. doi: 10.1016/j.fertnstert.2016.11.003. Epub 2016 Dec 1.

Abstract

Objective: To evaluate the effect of supplementing single-step embryo culture medium with insulin on human embryo development.

Design: Comparative study.

Setting: Two private centers.

Patient(s): The study involved a sibling oocyte split of 5,142 retrieved oocytes from 360 patients.

Intervention(s): Sibling oocytes split after intracytoplasmic sperm injection for culture from day 0 through day 5 or 6 in insulin-supplemented or control medium. Women were split to receive their embryos from insulin-supplemented or control medium.

Main outcome measure(s): Clinical pregnancy rate.

Result(s): There were significantly higher rates of clinical, ongoing, and twin pregnancies in the insulin-supplemented arm than in the control arm. On day 3, embryo quality and compaction were higher in insulin-supplemented medium. On day 5, insulin supplementation showed higher rates of blastocyst formation, quality, and cryopreservation.

Conclusion(s): Insulin supplementation of single-step embryo culture medium from day 0 through day 5 or 6 improved clinical pregnancy rate and human embryo development. However, these findings need further confirmation through a multicenter randomized controlled trial that may include other patient populations and different culture media.

Keywords: Embryo culture media; blastocyst; insulin embryonic effect.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Blastocyst / drug effects*
  • Cryopreservation
  • Culture Media / adverse effects
  • Culture Media / chemistry*
  • Egypt
  • Embryo Culture Techniques*
  • Embryo Transfer
  • Embryonic Development / drug effects
  • Female
  • Fertility
  • Fertility Agents, Female / adverse effects
  • Fertility Agents, Female / therapeutic use*
  • Humans
  • Infertility / diagnosis
  • Infertility / physiopathology
  • Infertility / therapy*
  • Insulin / adverse effects
  • Insulin / therapeutic use*
  • Male
  • Oocyte Retrieval
  • Pregnancy
  • Pregnancy Rate
  • Pregnancy, Twin
  • Prospective Studies
  • Sperm Injections, Intracytoplasmic* / adverse effects
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Culture Media
  • Fertility Agents, Female
  • Insulin