Abstract

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.