Do antioxidants in the culture media improve IVF outcomes?

This study looked at whether adding antioxidants to the media used to culture oocytes (eggs) improved outcomes from in vitro fertilization (IVF). It found that antioxidant media led to more good quality embryos and higher pregnancy rates than standard media.

IVF is an infertility procedure in which oocytes (eggs) are collected and fertilized outside the body. The fertilized embryos are cultured in a laboratory setting for between three and five days. Then, the embryos are implanted into the woman’s uterus or frozen for use in a future cycle.

Culture media are gels or solutions used to grow oocytes or other cells in the laboratory. In the body, cells are bathed in a warm liquid containing salts, sugars, and proteins. Culture media imitate this environment.

Oocytes and embryos are sensitive to damage from oxygen and reactive oxygen species. Routine laboratory procedures expose culture media to air, which contains more oxygen than the internal body. Antioxidants are molecules that can protect against oxygen damage. The female reproductive tract contains antioxidants, but it is not common practice to add antioxidants to culture media. It is unclear whether including antioxidants in cell culture media can improve IVF outcomes.

This study included 133 couples undergoing IVF, from whom 1,563 oocytes were collected. The oocytes were randomly assigned to standard embryo culture media or to media plus antioxidants. Three antioxidants (A3) were used: acetyl-L-carnitine, N-acetyl-L-cysteine, and alpha-lipoic acid.

A similar number of oocytes were fertilized in both groups. Embryos were assessed for quality by whether they appeared normal under a microscope. A significantly higher percentage of embryos in the antioxidant group were good quality (50.3% vs. 40.7%).

A single embryo was chosen for transfer based on embryo quality. Of the transferred embryos, 71 were cultured in standard media and 81 in antioxidant media. More of the antioxidant media embryos led to a pregnancy confirmed by fetal heartbeat (47.1% vs. 37.8%). For female patients between ages 35 and 40, antioxidant media embryos led to significantly more ongoing pregnancies (50% vs. 25.8%).

This study found that using antioxidants in the culture media led to better IVF outcomes, particularly in women aged 35 to 40.

This study used a small number of patients. More studies are needed.