COCULTURE OF EMBRYOS ON HOMOLOGOUS ENDOMETRIAL CELLS IN PATIENTS WITHREPEATED FAILURES OF IMPLANTATION

Objective: To evaluate the value of coculture of embryos on endometria l cells in patients with repeated failures of implantation. Design: A retrospective comparison of pregnancy rates between IVF-ET with cocult ure and standard culture methods. Patients: Ninety patients with repea ted failures of transfer (range 4 to 11) underwent IVF-ET for a variet y of disorders. Method: Embryos were cocultured on homologous endometr ial cells and transferred on day 4 after retrieval of oocytes. Results : The overall pregnancy rate for these patients was 21% per transfer v ersus 8% in previous IVF-ET cycles. A higher percentage (28%) was obta ined for women < 39 years of age or on transfer of at least one morula (32.5% pregnancy per transfer). Conclusion: Coculture of embryos on h omologous 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 wit h repeated failures of implantation and also may be of value for asses sing 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.