title: Importance of the biopsy date in autologous endometrial cocultures for patients with multiple implantation failures.
abstract: OBJECTIVE
  To analyze the effectiveness of autologous endometrial coculture by the cycle day of the endometrial biopsy.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  University-based IVF center.
  
  
  METHODS
  Two hundred eight patients with multiple IVF failures.
  
  
  METHODS
  Embryos were split and randomly allocated to growth on autologous endometrial coculture or conventional media.
  
  
  METHODS
  Embryo quality and pregnancy outcome.
  
  
  RESULTS
  The overall clinical pregnancy rate was 41.8%. Embryos grown on autologous endometrial coculture were of higher quality (more blastomeres and less fragmentation) than embryos grown with conventional media. Early luteal biopsies (<5 days after LH surge) for autologous endometrial coculture did not demonstrate an improvement in embryo quality as compared to the significant improvement demonstrated with later luteal endometrial biopsies (> or =5 days after LH surge). The date of the biopsy was predictive of pregnancy outcome when using autologous endometrial coculture (44.7% [> or =5 days after LH surge] vs. 18.8% [<5 days after LH surge], P=.012).
  
  
  CONCLUSIONS
  We have demonstrated an improvement in embryo quality when using autologous endometrial coculture. The improvement in embryo quality and higher pregnancy rates were limited to biopsies > or =5 days after the LH surge. This suggests that mid/late luteal phase endometrium contains factors that enhanced embryo growth and subsequent implantation.
authors.affiliation: The Center for Reproductive Medicine and Infertility, Department of Obstetrics and Gynecology, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, New York 10021, USA. sdspando@mail.med.cornell.edu
authors.forename: Steven D
authors.initials: SD
authors.lastname: Spandorfer
authors.forename: Larry I
authors.initials: LI
authors.lastname: Barmat
authors.forename: Jose
authors.initials: J
authors.lastname: Navarro
authors.forename: Hung-Ching
authors.initials: HC
authors.lastname: Liu
authors.forename: Lucinda
authors.initials: L
authors.lastname: Veeck
authors.forename: Zev
authors.initials: Z
authors.lastname: Rosenwaks
mesh_terms: D000328:Adult; D001706:Biopsy / Q000379:methods; D001755:Blastocyst / Q000502:physiology; D018920:Coculture Techniques; D046508:Culture Techniques; D010064:Embryo Implantation; D004717:Endometrium / Q000473:pathology* / Q000503:physiopathology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007246:Infertility / Q000473:pathology* / Q000503:physiopathology* / Q000628:therapy; D007986:Luteinizing Hormone / Q000378:metabolism; D008597:Menstrual Cycle / Q000502:physiology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies; D013997:Time Factors; D017211:Treatment Failure
chemical_list: D007986:Luteinizing Hormone