Successful human in vitro fertilization using a modified human tubal fluid medium lacking glucose and phosphate ions.

OBJECTIVE

To determine the effect of medium with or without glucose and phosphate on the fertilization and development of human oocytes.

DESIGN

Sequential allocation of alternate patients to one of two treatment groups.

SETTING

Private practice infertility programs.

PATIENTS

Ten couples requesting treatment for infertility.

INTERVENTIONS

Gametes from each couple were collected, washed, and incubated in one of two culture media under investigation.

MAIN OUTCOME MEASURES

Number of oocytes collected, fertilized, cleaving, replaced, and implanting in each patient. Development of any supernumerary embryos to fully expanded blastocysts in vitro.

RESULTS

There was a significant increase in the proportion of transferred embryos implanting in the group of patients whose gametes were handled in medium devoid of glucose and phosphate. All other comparisons of factors that may have influenced implantation rates between the two groups of patients were not significantly different.

CONCLUSIONS

High rates of fertilization, cleavage, implantation, and development of supernumerary human embryos to the blastocyst stage in vitro were obtained with a modified human tubal fluid medium containing ethylenediaminetetraacetic acid and glutamine but devoid of glucose and phosphate ions. A prospective randomized trial is necessary to evaluate the clinical significance of these observations.