Culture media with antioxidants improved preimplantation embryo development and clinical outcomes of patients of advanced age.

Research question: What are the clinical effects of using culture media supplemented with antioxidants (AOX) throughout the IVF process?

Design: Prospective randomized single-centre study. Cumulus-oocyte complexes and semen samples collected from 127 treatment cycles were divided evenly between the study arm (culture media with AOX) and the control arm (culture media without AOX). The primary endpoint was the good-quality blastocyst (GQB) rate on day 5-6 per metaphase II (MII) oocyte.

Results: Fertilization rate and day 5-6 blastocyst rate per MII oocyte differed significantly in favour of the study arm, whereas GQB rate did not. A subgroup analysis, stratified by maternal age, revealed significant improvements in the study arm for day 3 embryo development rate, day 5-6 blastocyst rate, GQB rate and blastocyst utilization rate for patients aged 35-40 years, while the impacts on these endpoints were much smaller in patients aged <35 years. Ninety-four single vitrified blastocyst transfers (SVBT) were performed in each arm. The blastocysts derived from the study arm showed better results of SVBT for patients aged 35-40 years, defined by embryo implantation rate, fetal heartbeat rate and live birth rate, whereas these variables did not differ significantly between the two arms when assessing the results for patients of all ages and patients aged <35 years.

Conclusions: Embryo development and SVBT outcomes of treatment cycles of patients aged 35-40 years improved significantly when using AOX-supplemented culture media throughout the IVF process.