Clinical experience and perinatal outcome of blastocyst transfer after coculture of human embryos with human endometrial epithelial cells: a 5-year follow-up study.
OBJECTIVE
To evaluate the reproductive and neonatal outcome of blastocyst transfer after coculture with human endometrial epithelial cells in IVF and oocyte donation.


METHODS
Retrospective study. Private assisted reproductive center.


METHODS
Two hundred sixty women undergoing IVF and 469 oocyte recipients.


METHODS
IVF or intracytoplasmic sperm injection (ICSI) and transfer of at least one blastocyst after coculture with human endometrial epithelial cells.


METHODS
Blastocyst formation rate, implantation and pregnancy rates, neonatal outcome, and congenital birth defects.


RESULTS
Among patients who had transfer with their own oocytes, 1193 of 2349 cocultured embryos developed up to the blastocyst stage (50.8%), and pregnancy and implantation rates of 33.9% and 19.2%, respectively, were achieved. In the oocyte donation program, 1819 blastocysts were obtained from 3127 embryos (58.2%), with subsequent pregnancy and implantation rates of 57.0% and 31.0%, respectively. The blastocyst rate remained stable throughout the 5 years of the study, but the pregnancy and implantation rates increased dramatically. Of 139 deliveries, 57 (41.0%) were multiple pregnancies and 1 (0.7%) was a multifetal birth (four live born infants). Out of 200 children born, 59% were male, and congenital birth defects were observed in 2.5%.


CONCLUSIONS
Coculture of human embryos with endometrial epithelial cells yields a blastocyst formation rate of 50.8% to 58.2% and encouraging implantation and pregnancy rates. This technique reduces the mean number of embryos transferred in each patient. The number of embryos implanted is more relevant to neonatal outcome than is the coculture system and blastocyst transfer used. The risk of congenital birth defects associated with this program is similar to that recorded in early ET in IVF or ICSI.
Mercader
Amparo
A
Instituto Valenciano de Infertilidad, Valencia, Spain.
Garcia-Velasco
Juan A
JA
Escudero
Ernesto
E
Remohí
José
J
Pellicer
Antonio
A
Simón
Carlos
C
D000328:Adult; D018920:Coculture Techniques; D000013:Congenital Abnormalities / Q000453:epidemiology; D010064:Embryo Implantation; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000502:physiology*; D004717:Endometrium / Q000166:cytology*; D004847:Epithelial Cells / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012744:Sex Ratio