Autologous endometrial coculture
Encyclopedia
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 (IVF) pregnancy.
1. Once a patient has been deemed an appropriate candidate for the procedure, she undergoes an endometrial biopsy
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.
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 embryo
s 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
.
better than sequential culture media; 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
s were 39% vs. 28% and implantation rates 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.
Assisted reproductive technology
Assisted reproductive technology is a general term referring to methods used to achieve pregnancy by artificial or partially artificial means. It is reproductive technology used primarily in infertility treatments. Some forms of ART are also used in fertile couples for genetic reasons...
. 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 (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
Biopsy
A biopsy is a medical test involving sampling of cells or tissues for examination. It is the medical removal of tissue from a living subject to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically...
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.
4. The patient’s eggs are retrieved and mixed with the sperm
Spermatozoon
A spermatozoon is a motile sperm cell, or moving form of the haploid cell that is the male gamete. A spermatozoon joins an ovum to form a zygote...
. At this time, the lab begins thawing and growing her endometrial cells.
5. Once fertilization is confirmed, the patient’s embryo
Embryo
An embryo is a multicellular diploid eukaryote in its earliest stage of development, from the time of first cell division until birth, hatching, or germination...
s 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
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...
.
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 significantlyStatistical significance
In statistics, a result is called statistically significant if it is unlikely to have occurred by chance. The phrase test of significance was coined by Ronald Fisher....
better than sequential culture media; 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
Pregnancy rate in infertility treatment is the success rate for pregnancy. 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 simple artificial insemination or AI...
s were 39% vs. 28% and implantation rates 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.