title: A randomized control comparison study of culture media (HTF versus P1) for human in vitro fertilization.
abstract: OBJECTIVE
  It is now widely accepted that increasing the number of replacement embryos (>3 embryos per embryo transfer [ET]) is associated with an increased risk of multiple pregnancies. While embryo reduction is often proposed when there is a high risk of multiple pregnancies, it is a difficult decision for the couple. For this reason, different studies have focused on single embryo transfer, more precisely blastocyst transfer. The aim of the study is to confirm that phosphate-free culture media can be used to generate greater quality embryos.
  
  
  RESULTS
  We carried out a study to compare the efficacy of human tubal fluid (HTF) versus preimplantation stage one (P1) as culture media for assisted reproductive therapy (ART). In 109 nonselected patients, we obtained an embryo fertilization rate with HTF and P1 culture media of 58.6 and 62.5% (P = 0.003), respectively. After 48 and 72 h, the morphology was similar for both P1 and HTF embryos in most patients. However, in the same patients, when HTF embryo quality was low (15.4%), P1 embryo quality was significantly higher 68.7% (P = 0.002). Some embryos were transferred at 48 h and some at 72 h after retrieval, in a randomized manner. We transferred a maximum of up to three embryos per ET. The implantation rate was significantly different; at 48 h, it was 6.8 and 12.2% for HTF and P1, respectively (P = 0.02). The pregnancy rate was 17.1% for HTF embryos and 23.7% for P1 embryos (P = 0.02).
  
  
  CONCLUSIONS
  Therefore, we observed a significant difference between P1 and HTF in the fertilization rate, in embryo quality, in implantation rate and in pregnancy rate. But the most important difference between this study and others is that every patient was the control of herself, so we eliminated every variable.
authors.affiliation: Department of Reproductive Medicine and Child Development, Division of Obstetrics and Gynecology, University of Pisa, Via Roma 35, 56100 Pisa, Italy. g.artini@obgyn.med.unipi.it
authors.forename: Paolo G
authors.initials: PG
authors.lastname: Artini
authors.forename: Valeria
authors.initials: V
authors.lastname: Valentino
authors.forename: Vito
authors.initials: V
authors.lastname: Cela
authors.forename: Francesca
authors.initials: F
authors.lastname: Cristello
authors.forename: Alessandra
authors.initials: A
authors.lastname: Vitè
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Genazzani
mesh_terms: D003470:Culture Media; D046149:Embryo Culture Techniques; D010064:Embryo Implantation; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D011247:Pregnancy; D018873:Pregnancy Rate; D011272:Pregnancy, Multiple
chemical_list: D003470:Culture Media