Serum is more effective than albumin in promoting human embryo development and implantation.
OBJECTIVE
To compare the effects of serum with those of Albuminar-5 (Armour Pharmaceutical Co., Eastbourne, Sussex, United Kingdom) as medium supplements to Earl's balanced salt solution (EBSS) for IVF and subsequent embryo development.


METHODS
A retrospective study. Gametes and embryos from 318 patients were cultured in the presence of serum (group 1). Gametes and embryos from 130 patients were cultured in the presence of Albuminar-5 (group 2). Embryos obtained from IVF were replaced into the uterus within 48 hours after insemination. Surplus bipronucleate embryos were cultured up to 14 days with either serum or Albuminar-5.


METHODS
Two tertiary referral fertility clinics; university teaching hospital.


METHODS
Four hundred forty-eight patients with a wide spectrum of causes of subfertility, ranging in age from 24 to 43 years.


METHODS
Fertilization rate, pregnancy rate (PR), implantation rate, and surplus embryo development in vitro.


RESULTS
The PR for group 1 patients was higher than that of group 2 (27.0% versus 15.4%, respectively). Although fertilization rates were identical in the two groups, cumulative embryo scores and implantation rates were significantly higher in group 1. There was no difference between the groups in age distribution, types of ovarian stimulation, numbers of patients with day 1 or day 2 transfers, or luteal phase support. Of 31 embryos cultured with serum, 54.8% reached the fully expanded blastocyst stage and 25.8% hatched. Of 19 embryos cultured with Albuminar-5, only 5.3% reached the fully expanded blastocyst stage and none hatched.


CONCLUSIONS
The results suggest that, under certain conditions, serum supplementation yields better results than protein supplementation alone. The latter may be suitable only in conjunction with additional components.
Hargreaves
C A
CA
Department of Obstetrics, Gynaecology and Reproductive Physiology, St. Bartholomew's Hospital, London, United Kingdom.
Rahman
F
F
Cowan
D
D
Santis
M
M
Keefe
T
T
Howell
R J
RJ
Chard
T
T
Homa
S T
ST
D000328:Adult; D001755:Blastocyst / Q000502:physiology; D001769:Blood; D003470:Culture Media; D046508:Culture Techniques; D010064:Embryo Implantation; D004624:Embryo Transfer; D005314:Embryonic and Fetal Development; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D012709:Serum Albumin
D003470:Culture Media; D012709:Serum Albumin