Clinical Assisted Reproduction Autologous Endometrial Coculture in Patients with a Previous History of Poor Quality Embryos1

Purpose: To evaluate the effect of autologous endometrial coculture in patients (less than 36 years old) with a history of a single IVF failed cycle associated with poor quality embryos. Methods: Design: Controlled clinical study. Setting: University-based in vitro fertilization cen-ter. Patients: Twenty-six patients with a history of a single prior failed IVF-ET with poor pre-embryo quality. Intervention(s): Autologous endometrial coculture. Main outcome measures: Preembryo blastomere numbers and cytoplasmic fragmentation rates were compared between the treatment and previous cycle. Clinical pregnancy rates were analyzed. Results: Twenty-six women with an average age of 32:8 § 2:9 years underwent treatment. On Day 3 the overall mean number of blastomeres per preembryo on coculture compared to conventional medium in a previous cycle was 6:1 § 1:8 vs. 5:1 § 1:3 (P D 0:01; Wilcoxon test). The average percentage of cytoplasmic fragments on coculture compared to the conventional medium in a previous cycle was 14% § 10 vs. 22% § 13 (P D 0:003; Wilcoxon test). At transfer the mean number of blastomeres per preembryo on coculture was 7:4 § 1:8 compared to 6:7 § 1:5 on conventional medium in a previous cycle (P D 0:02; Wilcoxon test). The clinical pregnancy rate (positive fetal cardiac activity) per patient was 88.5%. The delivery rate was 73.1 % (19/26). Conclusions: There was an improvement in the preembryo quality for preembryos on autol-ogous endometrial coculture compared to noncocultured preembryos from the same patient in a previous cycle. An excellent delivery rate was subsequently found. KEY WORDS: endometrial; preembryo quality; coculture