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The complexity of human reproduction shows that many factors may play a role in the success or failure of IVF.
Egg and embryo quality, the transfer of the embryo(s) into the uterine cavity, and the cellular and molecular environment surrounding implantation. These factors are all very important for the ultimate goal of creating a pregnancy that leads to a live healthy baby.

The culture
media used in the IVF laboratory bath and feed the embryos until transfer. Recent advances in the laboratory conditions had a great impact on IVF success rates and we now reached to the point that 50-55% of egg retrievals will result in a pregnancy.
Unfortunately, not all patients conceive with their 1st IVF procedure and they should repeat the treatment cycles. Implantation issues are probably the most common reason that IVF treatment fails.
Patients with repeated implantation failures or poor embryo quality may benefit from embryo culture using the co-culture techniques.
Autologous Co-culture is a technique of IVF culture system. Several infertility clinics in the world have been using this technique since 1996. It involves placing a patient's fertilized eggs on top of a layer of cells from her own uterine lining or granulosa cells, thus creating directly a natural environment for embryo development. Both cell lines are derived from the patient, thereby eliminating any concerns regarding transmission of viruses.

Co-culture technique is not applied universally to all cases in an IVF program. It is usually used for the "poor prognosis" patients. Studies have suggested that these patients can benefit from IVF with co-culture. These group of patients consist of couples who have failed previous IVF cycles or who have poor embryo quality.

How is endometrial Co-culture technique performed?
The candidate undergoes an endometrial biopsy during which a small piece of her uterine lining is removed on an appropriate date for having the necessary cells. The endometrial sample is treated, purified and sometimes frozen for future use in the embryology lab. The patient then starts a IVF-ICSI cycle and is given medication to stimulate egg growth in her ovaries. The patient's eggs are retrieved and processed with IVF and or ICSI. Once fertilization is observed, these embryos are placed on top of her own endometrial cells. Over the next two to four days, the embryos are closely monitored for growth and development and then transferred to the woman.

Co-culture medium have been shown to produce different growth factors which are important for cell development. This helps to improve the quality and implantation of embryos. Co culture cells in media provides also an opportunity to detoxify the medium that the embryos are growing in.

It is also possible to freeze co-culture embryos. Co-culture will not affect the ability of your embryos to freeze well. We use the same standards for freezing co-cultured embryos as we do for standard cultured embryos. If your embryo quality is improved with co-culture, there is a greater likelihood that we will be able to freeze more embryos for you.
The risks of Co-culture are minimal. The procedure has been performed in many patients with no reported detrimental effects on embryo growth. Complications involving uterine infection or damage caused by embryo biopsy are extremely rare.

References:

 

1. Barmat LI, Worrilow KC, Paynton BV. Growth factor expression by human oviduct and buffalo rat liver co culture cells. Fertil Steril 1997; 67:775–9.
2. Spandorfer SD, Pascal P, Parks J, Clark R, Veeck L, Davis OK, Rosenwaks Z. Autologous endometrial coculture in patients with IVF failure: outcome of the first 1,030 cases. J Reprod Med. 2004 Jun;49(6):463-7
3. Eyheremendy V, Raffo FG, Papayannis M, Barnes J, Granados C, Blaquier J. Beneficial effect of autologous endometrial cell coculture in patients with repeated implantation failure. Fertil Steril. 2010 Feb;93(3):769-73.
 

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