Human Reproduction, Vol 12, 2263-2266, Copyright © 1997 by Oxford University Press
H Laverge, P De Sutter, R Desmet, J Van der Elst and M Dhont
The use of human serum albumin (HSA) instead of fetal cord serum (FCoS) as
protein supplement highly simplifies the preparation of culture medium for
human in-vitro fertilization (IVF) but whether they are equivalent in
sustaining embryo development is still controversial. We performed a
prospective randomized study of patients undergoing IVF or intracytoplasmic
sperm injection (ICSI) where embryos were cultured in Earle's balanced salt
solution containing either 8% (v/v) FCoS or 0.4% (w/v) HSA as protein
source. Fertilization rates, morphological embryonic quality and pregnancy
rates were compared. A total of 2189 oocytes from 210 cycles were cultured
in medium supplemented with HSA in patient group 1 and 2109 oocytes from
203 cycles in medium supplemented with FCoS in patient group 2. The
fertilization rate, defined as the presence of two nuclei, for
microinjected oocytes was similar in both patient groups (77.4 and 76.7%,
respectively). The fertilization rate for inseminated oocyte-cumulus
complexes was significantly higher in the HSA group than in the FCoS group
(62.9 versus 53.8%, P < 0.025). The embryonic quality was significantly
better after culture in medium supplemented with HSA than with FCoS (13.7
versus 9.9% morphologically excellent embryos, P < 0.001). Implantation
rates per transferred embryo were not significantly different (22.5 versus
18.2%), but there was a significantly higher pregnancy rate per embryo
transfer in the HSA group (45.7 versus 35.9%, P < 0.05, respectively).
Non-evolutive pregnancy rates were significantly different (27.4 and
16.7%). Our data demonstrate that the use of human serum albumin as a
protein supplement for culture medium in human IVF programmes is associated
with improved embryonic quality and significantly higher pregnancy rates.
For this reason as well as the additional benefits of being virus-free and
being purified, HSA is preferable to FCoS for the preparation of culture
media in human IVF.
ARTICLES
Prospective randomized study comparing human serum albumin with fetal cord serum as protein supplement in culture medium for in-vitro fertilization
Infertility Centre, Department of Obstetrics and Gynaecology, University Hospital, Ghent, Belgium.
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