Cytokines hold promise for human embryo culture in vitro: results of a randomized clinical trial

To evaluate the effects of cytokine enrichment of culture medium on embryological and clinical outcomes after intracytoplasmic sperm injection (ICSI). A randomized clinical trial. In vitro fertilization centers. This trial included 443 ICSI cycles randomized into two groups. This study evaluated the influence of integration of granulocyte-macrophage colony-stimulating factor, heparin-binding epidermal growth factor-like growth factor, and leukemia inhibitory factor into culture media on human embryo development after ICSI. Ongoing pregnancy rate per a randomized participant. Cytokine enrichment of culture medium showed improvement in ongoing pregnancy rate compared with no cytokines (106/224 [47%] vs. 78/219 [36%]; absolute rate difference [ARD] = 12; 95% confidence interval [CI], 2.5–21). This integration of cytokines also showed better rates of live birth (101/224 [45%] vs. 71/219 [33%]; ARD = 13; 95% CI, 4–21) and cumulative live birth (132/224 [60%] vs. 97/219 [44%]; ARD = 12; 95% CI, 4–20) and lower rate of pregnancy loss (27/124 [22%] vs. 37/103 [36%]; ARD = –14; 95% CI, –26 to –2) than conventional medium. Embryos developed in the cytokine-supplemented medium showed better blastocyst formation, quality, cryopreservation, and use than control medium. Integration of cytokines into human embryo culture media showed improvement in embryological and clinical outcomes after ICSI. However, the long-term effect of cytokine enrichment of a medium is still unclear and warrants further studies with longitudinal follow-up. NCT02420886 at ClinicalTrials.gov. Las citoquinas son prometedoras para el cultivo in vitro de embriones humanos: resultados de un estudio clínico aleatorizado. Evaluar los efectos de enriquecimiento con citoquinas del medio de cultivo en los resultados clínicos y embriológicos después de inyección intracitoplasmática de espermatozoides (ICSI). Un estudio clínico aleatorizado. Centros de fecundación in vitro. El estudio incluyó 443 ciclos de ICSI aleatorizados en dos grupos. Este estudio evaluó la influencia de la integración del factor estimulante de colonias de granulocitos-macrófagos, el factor de crecimiento similar al factor de crecimiento epidérmico ligado a la heparina y el factor inhibidor de leucemia en medios de cultivo de desarrollo de embriones humanos después de ICSI. Tasa de gestación evolutiva por paciente aleatorizada. El enriquecimiento con citoquinas de los medios de cultivo mostró una mejora en la tasa de gestación evolutiv