Autologous Endometrial Coculture is a technique of
assisted reproductive technology. It involves placing a patient’s fertilized eggs on top of a layer of cells from her own uterine lining, creating a more natural environment for embryo development and maximizing the chance for an
in vitro fertilization
In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm in vitro ("in glass"). The process involves monitoring and stimulating an individual's ovulatory process, removing an ovum or ova (egg or eggs) f ...
(IVF) pregnancy.
How Coculture is performed
A typical Coculture cycle consists of the following steps:
1. Once a patient has been deemed an appropriate candidate for the procedure, she undergoes an endometrial
biopsy
A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a dise ...
during which a small piece of her uterine lining is removed.
2. The uterine lining sample is sent to a research lab, where it is treated, purified and frozen.
3. The patient then undergoes a typical IVF cycle and is given medication to stimulate egg growth in her
ovaries
The ovary is an organ in the female reproductive system that produces an ovum. When released, this travels down the fallopian tube into the uterus, where it may become fertilized by a sperm. There is an ovary () found on each side of the body. T ...
.
4. The patient’s eggs are retrieved and mixed with the
sperm. At this time, the lab begins thawing and growing her endometrial cells.
5. Once fertilization is confirmed, the patient’s
embryos are placed on top of her own (and now thawed) endometrial cells.
6. Over the next two days, the embryos are closely monitored for growth and development.
7. The patient’s embryos are transferred into her uterus for implantation and
pregnancy
Pregnancy is the time during which one or more offspring develops (gestation, gestates) inside a woman, woman's uterus (womb). A multiple birth, multiple pregnancy involves more than one offspring, such as with twins.
Pregnancy usually occur ...
.
The potential candidate
Coculture can be an effective treatment for patients who have failed previous IVF cycles or who have poor embryo quality.
Advantages
A study of 12,377 embryo cultures showed that endometrial coculture is
significantly better than
sequential culture media
In vitro fertilisation (IVF) is a process of fertilisation where an egg is combined with sperm in vitro ("in glass"). The process involves monitoring and stimulating an individual's ovulatory process, removing an ovum or ova (egg or eggs) f ...
; the rates (fraction) reaching blastocyst stage were 56% versus 46% in the coculture versus the sequential system, respectively, with own oocytes. With eggs from
ovum donations, the rates were 71% versus 56%, respectively.
Pregnancy rate Pregnancy rate is the success rate for getting pregnancy, pregnant. It is the percentage of all attempts that leads to pregnancy, with attempts generally referring to menstrual cycles where insemination or any artificial equivalent is used, which ma ...
s were 39% vs. 28% and
implantation rate Pregnancy rate is the success rate for getting pregnant. It is the percentage of all attempts that leads to pregnancy, with attempts generally referring to menstrual cycles where insemination or any artificial equivalent is used, which may be simpl ...
s were 33% vs. 21%.
In addition to being noninvasive and relatively pain free, Coculture can be performed during a short office visit. The procedure also can improve embryo quality and stimulate embryo growth.
Risks
The risks of Coculture are minimal. The procedure has been performed in over 1000 patients with no reported detrimental effects on embryo growth. Complications involving uterine infection or damage caused by endometrial biopsy are extremely rare.
References
{{Assisted reproductive technology
Assisted reproductive technology