title: Improved pregnancy rate after transfer of embryos grown in human fallopian tubal cell coculture.
abstract: OBJECTIVE
  To evaluate the embryonic behavior in vitro and the pregnancy and implantation rates of embryos grown in a human ampullary cell coculture system.
  
  
  METHODS
  In a prospective study, two pronuclei embryos were cultured on human ampullary feeder layers up to the two to six-cell and blastocyst stages and replaced either as tubal, uterine, or sequential transfers.
  
  
  METHODS
  Assisted reproductive technology program in a university-based hospital.
  
  
  METHODS
  Fifty women with a mean age of 35.6 years who went through a single coculture cycle. Thirty of the patients were admitted for in vitro fertilization (IVF) and 20 for tubal embryo transfer (TET).
  
  
  RESULTS
  The overall clinical pregnancy rate (PR) for all 50 patients was 44% per cycle (IVF, 37%; TET, 55%) and the implantation rate was 31.8% (IVF, 31.0%; TET, 32.6%). Sixty-eight percent of pregnant patients were over 35 years, and 68% had two previously failed assisted reproduction cycles. Five of 9 patients who received sequential transfers became pregnant. Three of the 22 pregnancies aborted (2 after sequential transfer), and there was one ectopic. Overall, 88% of two to six-cell stage embryos were of good quality.
  
  
  CONCLUSIONS
  The human ampullary coculture system produces better quality embryos, increased numbers of blastocysts with improved PRs and implantation rates. The beneficial effects of the feeder layer may be through the release of embryotrophic factors and detoxification of the medium by the cells. Coculture is a new concept in assisted reproduction and has tremendous potential in boosting conception rates by mimicking the in vivo environment.
authors.affiliation: Department of Obstetrics and Gynaecology, National University Hospital, Singapore.
authors.forename: A
authors.initials: A
authors.lastname: Bongso
authors.forename: S C
authors.initials: SC
authors.lastname: Ng
authors.forename: C Y
authors.initials: CY
authors.lastname: Fong
authors.forename: C
authors.initials: C
authors.lastname: Anandakumar
authors.forename: B
authors.initials: B
authors.lastname: Marshall
authors.forename: R
authors.initials: R
authors.lastname: Edirisinghe
authors.forename: S
authors.initials: S
authors.lastname: Ratnam
mesh_terms: D000328:Adult; D001755:Blastocyst / Q000502:physiology; D046508:Culture Techniques; D004624:Embryo Transfer; D005314:Embryonic and Fetal Development; D004848:Epithelium / Q000502:physiology; D005187:Fallopian Tubes / Q000166:cytology / Q000502:physiology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies