Beneficial effect of autologous endometrial cell coculture in patients with repeated implantation failure.

OBJECTIVE: To confirm the beneficial effect of endometrial coculture in patients with repeated failures with assisted reproductive techniques (ART). DESIGN: Patients with previous failures were offered a repetition of ART in conjunction with autologous endometrial coculture. SETTING: Private fertility center. PATIENT(S): Sixty-eight couples who had attempted 92 cycles of IVF or intracytoplasmic sperm injection without obtaining an evolutive pregnancy. INTERVENTION(S): Patients repeated one cycle of ART with concomitant endometrial coculture of their embryos. MAIN OUTCOME MEASURES(S): Comparative pregnancy and delivery rates in conventional ART cycles vs. cycles with autologous endometrial coculture. RESULT(S): In the previous 92 cycles (146 ETs, fresh plus frozen) only 8 pregnancies were initiated, and all ended in spontaneous abortion. Upon repeating 68 cycles (76 ETs) using coculture, 39 pregnancies were obtained, of which 19 resulted in live births, 10 are ongoing evolutive pregnancies, and 10 ended in spontaneous abortions. CONCLUSION(S): These results confirm the usefulness of autologous endometrial coculture for the treatment of patients with repeated implantation failure.

Effect of granulocyte-macrophage colony stimulating factor on growth, resistance to freezing and thawing and re-expansion of murine blastocysts.

Two-cell murine embryos were cultured for 72 h in the presence or absence of granulocyte-macrophage colony stimulating factor (GM-CSF), frozen for 60 days and, after thawing, cultured for an additional 24 h in the presence or absence of GM-CSF. During the initial 72 h period, GM-CSF did not influence the percentage of embryos reaching the expanded blastocyst stage, but there was a significant increase (P < 0.05) in the number of cells in the embryos grown with GM-CSF. Survival after thawing was not affected by previous exposure to GM-CSF, but re-expansion of the blastocoele was diminished in that group. Exposure to GM-CSF during the post-thaw period greatly enhanced re-expansion of the blastocoele. The presence of human serum albumin in the culture media is thought to have masked the beneficial effect of GM-CSF upon embryos.