Autologous Endometrial Coculture is a technique of

assisted reproductive technology Assisted reproductive technology (ART) includes medical procedures used primarily to address infertility. This subject involves procedures such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and cryopreservation of ga ...

. 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 in which an egg is combined with sperm in vitro ("in glass"). The process involves monitoring and stimulating the ovulatory process, then removing an ovum or ova (egg or eggs) from ...

(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, an interventional radiologist, or an interventional cardiology, interventional cardiologist. The process involves the extraction of sampling (medicine), sample ...

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 a gonad in the female reproductive system that produces ova; when released, an ovum travels through the fallopian tube/oviduct into the uterus. There is an ovary on the left and the right side of the body. The ovaries are endocr ...

.
4. The patient’s eggs are retrieved and mixed with the

sperm Sperm (: sperm or sperms) is the male reproductive Cell (biology), cell, or gamete, in anisogamous forms of sexual reproduction (forms in which there is a larger, female reproductive cell and a smaller, male one). Animals produce motile sperm ...

. At this time, the lab begins thawing and growing her endometrial cells.
5. Once fertilization is confirmed, the patient’s

embryo An embryo ( ) is the initial stage of development for a multicellular organism. In organisms that reproduce sexually, embryonic development is the part of the life cycle that begins just after fertilization of the female egg cell by the male sp ...

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 is the time during which one or more offspring gestation, gestates inside a woman's uterus. A multiple birth, multiple pregnancy involves more than one offspring, such as with twins. Conception (biology), Conception usually occurs ...

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; 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 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 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.

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