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Embryo development until blastocyst stage with and without renewal of single medium on day 3 [PDF Download]
Conclusion: No statistically significant difference was found between the groups with respect to the analyzed parameters. However, a non-significant trend was observed in favor of the group without medium renewal for clinical pregnancy and positive pregnancy rates (β::::-hCG).
208. Is changing embryo culture medium after day 3 detrimental? [Forum/Discussion]
from: Administrator (office@fertaid.com), Australia on 22/01/2018 11:58:43 AM Profession:
Comment: In a small, in-house study using donor oocytes, there was no apparent negative effect on outcome from leaving embryos in the same culture drop from day 1 to day 5.
Submission: This small, in-house study explored whether leaving embryos in the same culture medium from day 0/1 to day 5 was detrimental in any way to the outcome of the treatment cycle. The published data suggested it was not. This follows on from other studies also showing the same outcome - that is not changing the medium after 2 days of culture (when one is using global medium) does not appear to impact on embryo development.// This kind of in-house study has probably been done by other clinics and not published but it is an impotent observation. Most clinics will offer blastocyst culture to some or all of their clients, and changing embryos on day 3 involves considerable extra work including dish preparation the day before moving them and the actual transfer. Clinics using time-lapse technology also find changing the dishes on day 3 is inconvenient and losses the continuity of image processing. Often this function is carried out on the weekend which can be inconvenient and expensive for some staff. It involves extra media and dishes and space in the incubators for equilibration. If there are extra-embryonic factors in the culture media, these are lost.// The concept of changing the media after 2 days goes back a long way when concerns about ammonium buildup and embryo metabolism would the main topics of the day. However these concerns no longer have the same level of concern. The concept of sequential media remains an important topic for embryo labs and changing methodology is always difficult but this type of data may well cause some clinics to cease performing this step. //However, given the secretive nature of medium companies, it may be wrong to assume all global media will give the same outcome and given the complex nature of culture vessels and incubators, etc i.e. one own unique culture environment, it may be wise of each clinic to perform (with ethcial approval) a similar analysis and to monitor via clinics KPI dataset if such a change is OK.//Also there is a risk that clinics may no longer look at their embryos on day 2 or 3, waiting until day 5 to see if there are embryos to transfer. I personally would be concerned if this was the case since early cleavage examinations are a good monitor of culture conditions and clients may need reassurance on the likelihood of having a transfer.//
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