title: Differential growth of human embryos in vitro: role of reactive oxygen species.
abstract: OBJECTIVE
  To examine the relationship of early human embryonic development with the level of reactive oxygen species (ROS) in the culture media on the first day (day 1 ROS) after insemination.
  
  
  METHODS
  A prospective study.
  
  
  METHODS
  Patients undergoing assisted reproduction in a teaching hospital.
  
  
  METHODS
  Patients undergoing conventional IVF (n = 104; 115 cycles) and intracytoplasmic sperm injection (ICSI) (n = 91; 96 cycles) were included. Both fertilization and early cultures were performed in human tubal fluid with 5% serum substitute supplement.
  
  
  METHODS
  Day 1 ROS levels in the central well (sample) and the outer well (control) of each embryo culture dish were measured after overnight incubation by chemiluminescence assay using luminol as the probe.
  
  
  METHODS
  Fertilization rate and embryo quality at day 3 and 5 were recorded for each cycle. Age, parity, and demographic features were also compared.
  
  
  RESULTS
  High day 1 ROS levels in culture media were associated with low blastocyst rate, low fertilization rate, low cleavage rate, and high embryonic fragmentation with ICSI but not with conventional IVF. High day 1 ROS levels in culture media were associated with lower pregnancy rates in both IVF and ICSI cycles.
  
  
  CONCLUSIONS
  Reactive oxygen species generated in culture media by day 1 may be an important biochemical marker for early embryonic growth. Increased embryonic fragmentation and slow cleavage rate may be partially attributed to early exposure of embryos to high ROS levels in ICSI cycles. Differential growth of ICSI embryos incubated under identical conditions may be in part due to differences in ROS levels of the culture medium surrounding these embryos.
authors.affiliation: Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Bedaiwy
authors.forename: Tommaso
authors.initials: T
authors.lastname: Falcone
authors.forename: Maher S
authors.initials: MS
authors.lastname: Mohamed
authors.forename: Abdel A N
authors.initials: AA
authors.lastname: Aleem
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Sharma
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Worley
authors.forename: Julie
authors.initials: J
authors.lastname: Thornton
authors.forename: Ashok
authors.initials: A
authors.lastname: Agarwal
mesh_terms: D001755:Blastocyst / Q000166:cytology; D010064:Embryo Implantation; D005314:Embryonic and Fetal Development / Q000502:physiology*; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro; D006801:Humans; D066298:In Vitro Techniques; D007247:Infertility, Female / Q000209:etiology; D008297:Male; D009865:Oocytes / Q000166:cytology*; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D017382:Reactive Oxygen Species; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000166:cytology*
chemical_list: D017382:Reactive Oxygen Species