Cytokines hold promise for human embryo culture in vitro: results of a randomized clinical trial
Mohamed Fawzy, Mai Emad, Mohamed A Elsuity, Ali Mahran, Mohamed Y Abdelrahman, Ahmed N Fetih, Hazem Abdelghafar, Mohamed Sabry, Mohamed Nour, Salah M Rasheed, Mohamed Fawzy, Mai Emad, Mohamed A Elsuity, Ali Mahran, Mohamed Y Abdelrahman, Ahmed N Fetih, Hazem Abdelghafar, Mohamed Sabry, Mohamed Nour, Salah M Rasheed
Abstract
Objective: To evaluate the effects of cytokine enrichment of culture medium on embryological and clinical outcomes after intracytoplasmic sperm injection (ICSI).
Design: A randomized clinical trial.
Setting: In vitro fertilization centers.
Patient(s): This trial included 443 ICSI cycles randomized into two groups.
Intervention(s): This study evaluated the influence of integration of granulocyte-macrophage colony-stimulating factor, heparin-binding epidermal growth factor-like growth factor, and leukemia inhibitory factor into culture media on human embryo development after ICSI.
Main outcome measure(s): Ongoing pregnancy rate per a randomized participant.
Result(s): Cytokine enrichment of culture medium showed improvement in ongoing pregnancy rate compared with no cytokines (106/224 [47%] vs. 78/219 [36%]; absolute rate difference [ARD] = 12; 95% confidence interval [CI], 2.5-21). This integration of cytokines also showed better rates of live birth (101/224 [45%] vs. 71/219 [33%]; ARD = 13; 95% CI, 4-21) and cumulative live birth (132/224 [60%] vs. 97/219 [44%]; ARD = 12; 95% CI, 4-20) and lower rate of pregnancy loss (27/124 [22%] vs. 37/103 [36%]; ARD = -14; 95% CI, -26 to -2) than conventional medium. Embryos developed in the cytokine-supplemented medium showed better blastocyst formation, quality, cryopreservation, and use than control medium.
Conclusion(s): Integration of cytokines into human embryo culture media showed improvement in embryological and clinical outcomes after ICSI. However, the long-term effect of cytokine enrichment of a medium is still unclear and warrants further studies with longitudinal follow-up.
Clinical trial registration number: NCT02420886 at ClinicalTrials.gov.
Keywords: Blastocyst culture; culture media; cytokines; growth factor.
Copyright © 2019 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Source: PubMed