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 a nd phosphate on the fertilization and development of human oocytes. De sign: Sequential allocation of alternate patients to one of two treatm ent groups. Setting: Private practice infertility programs. Patients: Ten couples requesting treatment for infertility. Interventions: Gamet es from each couple were collected, washed, and incubated in one of tw o culture media under investigation. Main Outcome Measures: Number of oocytes collected, fertilized, cleaving, replaced, and implanting in e ach patient. Development of any supernumerary embryos to fully expande d blastocysts in vitro. Results: There was a significant increase in t he proportion of transferred embryos implanting in the group of patien ts whose gametes were handled in medium devoid of glucose and phosphat e. All other comparisons of factors that may have influenced implantat ion rates between the two groups of patients were not significantly di fferent. Conclusions: High rates of fertilization, cleavage, implantat ion, 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 necessa ry to evaluate the clinical significance of these observations.