Integrating insulin into single-step culture medium regulates human embryo development in vitro

Insulin supplementation of in vitro culture media may improve human embryo development and pregnancy rates.

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Volume 107, Issue 2, Pages 405–412


Mohamed Fawzy, M.D., Mohamed Sabry, M.D., Mohamed Nour, M.D., Mohamed Y. Abdelrahman, M.D., Eman Roshdy, M.D., Yasmin Magdi, M.Sc., Hazem Abdelghafar, M.D.



To evaluate the effect of supplementing single-step embryo culture medium with insulin on human embryo development.


Comparative study.


Two private centers.


The study involved a sibling oocyte split of 5,142 retrieved oocytes from 360 patients.


Sibling oocytes split after intracytoplasmic sperm injection for culture from day 0 through day 5 or 6 in insulin-supplemented or control medium. Women were split to receive their embryos from insulin-supplemented or control medium.

Main Outcome Measure(s)

Clinical pregnancy rate.


There were significantly higher rates of clinical, ongoing, and twin pregnancies in the insulin-supplemented arm than in the control arm. On day 3, embryo quality and compaction were higher in insulin-supplemented medium. On day 5, insulin supplementation showed higher rates of blastocyst formation, quality, and cryopreservation.


Insulin supplementation of single-step embryo culture medium from day 0 through day 5 or 6 improved clinical pregnancy rate and human embryo development. However, these findings need further confirmation through a multicenter randomized controlled trial that may include other patient populations and different culture media.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.