ALL IN on Innovation – Bringing New Life to CSCM-NX with the Day 0 Approach

August 22, 2024

In 2014, scientists at FUJIFILM Irvine Scientific were searching for ways to improve upon historical IVF results and success rates. When looking further into optimal culture conditions, they hypothesized that lower lactate concentrations in human embryo culture media could improve embryo development by decreasing metabolic stress on the oocyte and embryo caused by high lactate concentrations. With this in mind, they developed a culture medium that had the lowest lactate concentration when compared to other media on the market. They called this new medium CSCM-NX (Catalog # 90167), and its protein supplemented equivalent, CSCM-NXC (Catalog # 90168).

Officially released in 2017, CSCM-NX showed promising results. However, beginning in 2020, and with the help of the on-staff Clinical Coordinator, FUJIFILM Irvine Scientific was determined to gather additional data to narrow down what workflow made the greatest impact when using a low lactate medium.

Optimizing the Protocol

As the scientists continued to observe how labs modified their protocols to integrate CSCM-NX, they were intrigued by what they found. Preliminary research showed that labs that adjusted their culture protocol to complement CSCM-NX saw better results than labs that inserted it into their pre-existing protocol.

The data suggested that when CSCM-NX was introduced at the earliest opportunity—directly after oocyte identification at collection—labs saw significant improvements in blastocyst rates. This meant that the new media was most effective when introduced earlier than the conventional Day 1, leading FUJIFILM Irvine Scientific to call this new protocol the Day 0 Approach.

Improvements in success rates proved to be more than slight; they had real statistical significance! Labs that followed this protocol saw increased oocyte maturity and competency¹, increased normal fertilization², increased blastocyst rates on Day 5^{1, 2, 3}, and increased euploidy rates¹— all culminating in increased ongoing pregnancy rates and decreased miscarriage rates³. In contrast to this, laboratories that used CSCM-NX in conjunction with a traditional culture protocol—after fertilization check and identification of 2PNs—saw static results that had neutral impact on success rates.

After thoroughly investigating the results from the ongoing studies, it became clear that the scientists were not only correct in their original hypothesis that a low lactate medium would improve embryo development, but they also uncovered a completely new protocol to pair with it. The Day 0 Approach established itself as the optimal protocol for the novel CSCM-NX low lactate culture medium, proving that constant curiosity and dedication to moving the assisted reproductive technology field forward can produce amazing results.

ALL IN on Innovation

FUJIFILM Irvine Scientific remains committed to being ALL IN on innovation, from releasing new products to exploring the unknown potential of familiar ones. We are excited to discover more about the mechanisms behind low lactate culture, and we are proud that CSCM-NX has pioneered a new path for research areas in IVF that, for many years, have been considered fully explored. We look forward to what discoveries today’s dedicated scientists will bring to the forefront in the near future and how those discoveries will impact the next generation of embryo culture media.

Try the Day 0 Approach

---

References:

1. A. Brewer et al. (2023) Resulting success of early introduction to a low lactate continuous embryo culture medium versus a higher lactate sequential system. PCRS.
2. F. Benini et al. (2022) A low lactate undisturbed culture medium protocol provides an increase in usable blastocysts on day 5 vs day 6. ESHRE.
3. M. Kobanawa (2022) Fertilization, embryo culture and clinical results using low lactate embryo culture medium for pre-culture, insemination, and beyond. Reproductive Medicine and Biology Volume 21, Issue 1c.