| Abstract | | Background: There is a lack of clinical trials on the success of embryo culture in different commercial culture systems in the programme of in vitro fertilization (IVF). In our prospective study, embryo development was compared in two sequential media. Methods: The oocytes from each of 62 patients, treated by IVF/ICSI, were distributed into two groups for 5-day culture in the BlastAssistr System (Medicult, Denmark) (Group 1, n = 421) and in the GIII SeriesTM (Vitrolife, Sweden) (Group 2, n = 415) media. The dynamics of embryo development, implantation and pregnancy rates were compared between groups. Results: The differences between Groups 1 and 2 were first noted on day 3 when GIII yielded more fast-cleaving (> 6 cells) nonfragmented embryos (31.3 % vs. 44.4 %, P < 0.01). On day 4 however, a larger number of compact embryos was found in Group 1 (42.2 % vs. 28.7 %, P <0.005). The percentage of blastocysts or compact morulae on day 5 was the same in both groups (59.6 % vs. 55.6 %). But expanded blastocysts of optimal quality with oval inner-cell-mass developed more frequently in Group 1 (29.2 % vs. 17.7 %, P < 0.05), and therefore more transfers were performed exclusively with Group 1 embryos (28 vs. 17). Pregnancy and implantation rates were the same in both groups (53.6 % vs. 52.9 % and 34.7 % vs. 34.2 %,respectively). Conclusions: Although the GIII SeriesTM yields more fast-cleaving embryos on day 3, embryo compaction (morula) and cavitation (blastocoel) start earlier in the BlastAssistr System media. BlastAssistr System therefore allows easier selection of embryos for transfer on day 5.
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| Summary | | Izhodišče: V literaturi primanjkuje primerjalnih kliničnih raziskav o uspešnosti gojenja zarodkov v programu fertilizacije in vitro (IVF) v različnih komercialnih gojiščih. V naši prospektivni raziskavi smo primerjali razvoj zarodkov v dveh različnih sekvencijskih gojiščih. Metode: Jajčne celice vsakega od 62 parov, ki so bili v postopku IVF/ICSI, smo razdelili v dve skupini. V prvi skupini (Skupina 1, n=421) smo zarodke gojili pet dni v gojiščih BlastAssistr System (Medicult, Denmark), v drugi skupini (Skupina 2, n=415) pa v gojiščih GIII SeriesT (Vitrolife, Sweden). Med skupinama smo primerjali dinamiko embrionalnega razvoja, implantacijo in delež zanositev. Rezultati: Razliko med skupinama 1 in 2 smo najprej opazili tretji dan inkubacije, ko se je v GIII gojišču razvilo več večceličnih (> 6 celic) nefragmentiranih zarodkov (31, 3 % oz. 44,4 %; P < 0,01). Četrti dan je bilo več kompaktnih morul zabeleženih v skupini 1 (42,2 % oz. 28,7 %; P < 0,005). Peti dan razvoja je bil delež blastocist in morul skupaj enak v obeh skupinah (59,6 % oz. 55,6 %), vendar pa se je v Skupini 1 razvilo več ekspandiranih blastocist optimalne kakovosti z ovalno notranjo celično maso (29,2 % oz. 17,7 %; P < 0,05), zato smo v maternico pogosteje prenesli zarodke prav iz skupine 1 (28 oz. 17). Stopnja zanositve in implantacije je bila med skupinama primerljiva (53,6 % oz. 52,9 % in 34,7 % oz. 34,2 %). Zaključki: Čeprav so se do tretjega dneva starosti zarodki hitreje delili v gojiščih GIII SeriesT, sta se kompaktnost (morula) in kavitacija (blastocel) zarodka pojavila prej v gojiščih BlastAssistr System. BlastAssistr System je torej gojišče, ki omogoča boljšo selekcijo zarodkov zaprenos v maternico na peti dan razvoja.
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