Increased pregnancy rates for recurrent implantation failure cases with embryos developed on autologous endometrial co-culture obtained in mono layer and determination of target patient group

Abstract

Abstract Background: Although tremendous improvements have been implemented inconventional embryo culture systems, embryo side-products are still a major concern during extended culture. Although the cause of repeated implantation failure (RIF) seems to be multifactorial, several studies have indicated a possible beneficial role of endometrial co-culture systems on RIF cases via improving embryo quality and viability. This study is undertaken to analyze the cumulative contribution of endometrial co-culture (EC) in such cases compare with conventional culture results and to determine the most effective features to work. Methods: Overall, 678 cycles in which co-culture with the indication of recurrent implantation failure (n≥3) have been performed were included in the study. Patients were retrospectively grouped according to culture media systems used. In 329 patients (group I) endometrial co-culture has been of choice throughout the culture period and in 349 cycles conventional culture media has been utilized. From pre-zygote stage to embryo transfer, daily embryo growth parameters were scored and clinical pregnancy rates compared between groups according to female age, the number of previous attempts and number of mature oocytes obtained. Results: No statistically significant difference in main patient and cycle parameters such as female age, male age, BMI, gonadotropin ampoules used, MII oocytes collected and fertilized were found between groups. However, when embryo development characteristics were compared, PN (Pronucleus) arrest, cleavage arrest and 3rd day blastomere number and embryo fragmentation rates. Conclusios: Our results show that culturing embryos on endometrial monolayer cells seems to increase the cleavage rate and the quality of embryos in recurrent implantation failure cases. Furthermore, by comparing all of the results the main target group of this co-culture patients defined (older than 38 age and higher than 2 items) is very important for identified in order to assure the usefulness of co-culture.