COCULTURE OF HUMAN EMBRYOS WITH BUFFALO RAT-LIVER CELLS FOR WOMEN WITH DECREASED PROGNOSIS IN IN-VITRO FERTILIZATION

OBJECTIVE: The coculture of human embryos with epithelial cells may im prove both embryo quality and pregnancy rates. In this current study w e tested the efficacy of coculture with the buffalo rat liver cell lin e on pregnancy rates in women with a potentially poor prognosis for su ccess with in vitro fertilization (previous in vitro fertilization fai lure, advanced maternal age, increased early follicular follicle-stimu lating hormone levels, and anovulation). STUDY DESIGN: This prospectiv e controlled study evaluated a total of 203 women (135 coculture, 68 c ontrols) undergoing in vitro fertilization. Implantation rates per emb ryo, clinical pregnancy rates, and continuing/delivered pregnancy rate s were analyzed. RESULTS: Buffalo rat liver cells, which are commercia lly available, are stable in coculture. implantation rates (number of sacs with fetal heart motion per embryos transferred) were similar for coculture (19%) and control (18%) embryos, No difference in the rate of continuing/delivered pregnancies per retrieval was noted (17% cocul ture vs 14% central) in the group with advanced maternal age, but cocu lture caused a trend toward improved pregnancy rates in the group with ovulatory dysfunction (43% coculture vs 14% control) and the group wi th previous in vitro fertilization failure (34% coculture vs 28% contr ol). CONCLUSION: This is the first published controlled study to our k nowledge that reports the use of the buffalo rat liver cell coculture for human in vitro fertilization in a large number of patients. Our da ta support consideration of buffalo rat liver coculture for in vitro f ertilization for women with previous in vitro fertilization failure an d possibly for patients with oocyte or ovulatory dysfunction.