ASSISTED HATCHING WITH OR WITHOUT BOVINE OVIDUCTAL EPITHELIAL-CELL COCULTURE FOR POOR-PROGNOSIS IN-VITRO FERTILIZATION PATIENTS

Older patients and those who consistently return for embryo transfer b ut without implantation were studied to see if a combination of day 3 assisted hatching and co-culture (AH+CC) might be beneficial compared to assisted hatching alone (AH-alone). Female patients of greater than or equal to 38 years and couples who had previously failed to implant embryos three times or more were prospectively and randomly assigned to either an experimental or a control group. In the experimental grou p all embryos were cocultured on partial monolayers of bovine oviducta l epithelial cells for 2 days followed by assisted hatching by zona dr illing (AH+CC). All control embryos were cultured by standard procedur es until day 3 when they also underwent zona drilling prior to uterine transfer (AH-alone). With 50 cycles in each group there was unfortuna tely a marginal bias against the AH+CC group in that these patients ha d undergone a higher number of previous transfer cycles. There was a m arginally lower percentage of fragmentation and a significantly higher degree of zona thickness variability in the AH+CC embryo group. Embry onic implantation was significantly increased (P < 0.05) in the AH+CC group (18%) when compared to the AH-alone group (10%). This difference was reflected in a significantly higher (P < 0.05) initial pregnancy rate (52 versus 32%) in the AH+CC group, and a higher (not significant ) viable pregnancy rate (38 versus 22%).