Prospective randomized comparison of applying media with or without antioxidants during the entire IVF procedure on sibling gametes, subsequent embryo culture and single-vitrified blastocyst transfer

Background: To investigate the effect of antioxidants (AOX) on human embryo development and clinical outcome when used during all IVF procedures. Methods Prospective randomized single-centre study, where cumulus-oocyte complexes and semen samples from 127 treatment cycles were equally split between study and control (with/without AOX). The primary endpoint was Day 5/6 good quality blastocyst (GQB) rate / Metaphase-II (M-II) oocyte. Results The GQB rate between the study group and control was almost significant (P = 0.050). An age-related analysis revealed significantly higher fertilization rates in the study group for the older age groups (P < 0.05) but not in the younger. Development of Good-quality Day 3 embryos / M-II oocytes was comparable in the younger and significantly higher in the older age group (P < 0.05). Total Day 5/6 blastocyst rate and Day 5/6 GQB rate was not significantly different in the younger groups. For older patients Day 5/6 blastocyst rate and Day 5/6 GQB rate were higher in the study group (P < 0.05). Blastocyst utilization rates were comparable in younger patients and significantly different in older patients (P < 0.05). A total of 188 single vitrified blastocyst transfers were performed; 94 in each group. We noted similar implantation and ongoing pregnancy rates between in the younger age group but higher, albeit not-significant rates, for older patients in the study group (48.2% vs. 28.6%; 46.4% vs. 28.6%). Respective live birth rates were 47.4% vs 51.9% and 42.9% vs 23.8% in the younger/older age group. Conclusion Using media with AOX in all IVF procedures shows age-dependent effects. Trial regintration: Approval no: 16002