Page 81 - PCC02

Zhang et al., 2013
Short insemination
• No difference in
• normal fertilization (RR: 0.98, 95% CI: 0.93 – 1.02) • polyspermy (RR: 0.84, 95% CI: 0.7 – 1.01)
• good quality embryos (RR: 1.24, 95% CI: 1.0 – 1.53)
• Significantly higher rates of
• clinical pregnancy (RR: 1.84, 95% CI: 1.24–2.73)
• ongoing pregnancy (RR: 1.73, 95% CI: 1.27 – 2.33) • implantation (RR: 1.80, 95% CI: 1.43 – 2.26)
Risk of bias Numerous important variables, e.g.
• moderate/high • duration of short insemination (1‐5 h) • presence absence of cumulus cells
• insemination concentration
Culture media
• For detail coverage, see previous talk of this PCC:
- Composition and performance of commercial media for IVF (Dean Morbeck)
• Protein supplement
- Blood‐derived HSA probably the most widely used source
• Carrier for other biomolecules (fatty acids, steroids) and contaminants (octanoic acid, caprylate and transition metals)
- Synthetic serum substitute (SSS: HSA+16% and  globulins) • In a RCT, SSS was associated with a 11% increase in pregnancy rate,
but other studies highlighted high lot‐to‐lot variability in performance - Recombinant HSA
• Less used, fewer data
- De facto, we do not know
• Which is the best source and at what concentration should be used
at what stage
Wale and Gardner, 2015
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