Coculture of embryos on homologous endometrial cells in patients with repeated failures of implantation.

OBJECTIVE

To evaluate the value of coculture of embryos on endometrial cells in patients with repeated failures of implantation.

DESIGN

A retrospective comparison of pregnancy rates between IVF-ET with coculture and standard culture methods.

PATIENTS

Ninety patients with repeated failures of transfer (range 4 to 11) underwent IVF-ET for a variety of disorders.

METHOD

Embryos were cocultured on homologous endometrial cells and transferred on day 4 after retrieval of oocytes.

RESULTS

The overall pregnancy rate for these patients was 21% per transfer versus 8% in previous IVF-ET cycles. A higher percentage (28%) was obtained for women < 39 years of age or on transfer of at least one morula (32.5% pregnancy per transfer).

CONCLUSION

Coculture of embryos on homologous endometrial cells is both safe and ethical. It appears to be a valuable approach for the selection of a good quality embryo before transfer. The technique should prove to be of benefit to patients with repeated failures of implantation and also may be of value for assessing the respective responsibility of endometrium and embryo in these repeated failures. However, the mechanisms underlying this improvement need to be determined to simplify the procedure.