A prospective randomized comparison of sequential versus monoculture systems for in-vitro human blastocyst development

Background: Extending the period of in-vitro culture to the blastocyst stage may improve implantation rates in IVF treatment. Recognition of the dynamic nature of early embryo metabolism has led to the development of commercially available sequential culture systems. However, their improved efficacy over monoculture systems remains to be demonstrated in prospective studies. Methods: Embryos obtained from 158 women undergoing IVF treatment were randomized by sealed envelopes to culture in one of three systems: (A) culture for 5 days in our own monoculture medium (Rotterdam medium); (B) culture for 3 days in Rotterdam medium followed by 2 days in fresh Rotterdam medium; (C) culture for 5 days using the commercially available G1/G2 sequential culture system. Results: There were no significant differences in blastulation, implantation or pregnancy rates between the three tested culture systems. Conclusion: The employed monoculture system is as effective as the G1/G2 sequential system for the culture of blastocysts for IVF.