Objective: The aim of this study was to evaluate 3 methods of embryo selection in predicting the embryos with the best method of achieving pregnancy in single embryo transfer cycles, namely embryo morphology, glucose concentration and β-HCG concentration in the embryo culture medium.
Patients and Methods: A total of 66 embryos in 66 ICSI cycles were studied: 33 pregnant and 33 non-pregnant cycles. Each embryo was scored using the Veeck's scoring method and the spent culture medium of each embryo was analyzed for its content of glucose and β-HCG using previously validated methods.
Results: The results showed that the Veeck's embryo score, the measurement of glucose levels and the measurement of β-HCG levels in the spent culture medium are all reliable and practical methods to be used for this purpose. The Veeck's embryo score had the best predictability followed by β-HCG levels, followed by glucose levels in the culture medium. Combining the 3 methods was superior to each methods studied alone as well as any combination of 2 methods.
Conclusion: The measurement of glucose and β-HCG in the spent culture medium of individual embryos is an effective and practical method for embryo selection in patients treated with ICSI. Combining both methods with the Veeck's embryo score gives the best predictability. However, these findings should be confirmed by a prospective randomized study, preferably in single embryo transfer cycles.