Comparison of three embryo culture media: A randomized clinical trial with sibling oocytes

To evaluate the influence of three culture media on the good quality cleavage embryo and fertilization rates.

A three-arm, prospective, randomized, controlled clinical trial included patients undergoing IVF treatments at a single center from May to August 2023. Sibling oocytes were randomized in three culture media (A, B and C). Fertilization and day three good quality embryo rates were evaluated.

Three hundred sixty-four retrieved oocytes from forty patients were randomized right after ovarian aspiration. From those, 309 metaphase II oocytes (mean per patient 7.72±2.87) were fertilized and cultured. Overall fertilization rate was 81.6%, with no statistical difference among media: 85.8% (73-100) vs. 77.2% (63-100) vs. 82.4% (67-100) for A, B and C, respectively (p=0.290). Although the percentage of D3 good quality embryos in each media was not statistically significant [A: 52.3% (0-76), B: 35.9% (0-67), C: 44.8% (0-100) (p=0.137)], the number of patients with at least one good quality embryo on D3 was statistically different [28 (70.0%) vs. 18 (45.0%) for A and B, respectively (p=0.020) OR 1.56; 95% CI (1.05-2.32, p=0.020)]. In a multivariable analysis, culture media and age have significantly affected D3 embryo quality OR 1.44; 95% CI (1.22-2.35, p=0.016).

Although no difference was observed in fertilization and cleavage-stage embryo quality rate among brands, one culture medium had a significantly lower number of patients with good-quality cleavage embryos. Further trials with pregnancy outcomes are warranted to confirm clinical implications of these findings.