Integrating insulin into single-step culture medium regulates human embryo development in vitro.
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.
['Fawzy|Mohamed|M|', 'Sabry|Mohamed|M|', 'Nour|Mohamed|M|', 'Abdelrahman|Mohamed Y|MY|', 'Roshdy|Eman|E|', 'Magdi|Yasmin|Y|', 'Abdelghafar|Hazem|H|']
D000293:Adolescent D000328:Adult D001755:Blastocyst D015925:Cryopreservation D003470:Culture Media D004534:Egypt D046149:Embryo Culture Techniques D004624:Embryo Transfer D047108:Embryonic Development D005260:Female D005298:Fertility D005300:Fertility Agents, Female D006801:Humans D007246:Infertility D007328:Insulin D008297:Male D054315:Oocyte Retrieval D011247:Pregnancy D018873:Pregnancy Rate D059285:Pregnancy, Twin D011446:Prospective Studies D020554:Sperm Injections, Intracytoplasmic D013997:Time Factors D016896:Treatment Outcome D055815:Young Adult
blastocyst Embryo culture media insulin embryonic effect