Role of coculture in human in vitro fertilization: a meta-analysis.
OBJECTIVE
To evaluate the role of coculture in human IVF.


METHODS
Meta-analysis. SETTING/PATIENT(S)/INTERVENTION(S): A literature search was performed using the Cochrane Menstrual Disorders and Subfertility Group Trials register, the Cochrane Central register of Controlled Trials on the Cochrane Library (2006), and MEDLINE (January 1966 to March 2006).


METHODS
Primary outcomes measured were implantation rates and pregnancy rates (clinical and ongoing). Secondary outcomes included evaluation of pre-embryo development based on average number of blastomeres per embryo.


RESULTS
A total of 17 prospective, randomized trials were identified. There was an overall statistically significant effect of coculture on the implantation rate, clinical pregnancy rate, and ongoing pregnancy rate. The cocultured embryos had greater numbers of blastomeres, although the data were heterogeneous.


CONCLUSIONS
This is the first systematic, evidence-based review of randomized controlled trials to objectively determine the potential benefits of coculture in human IVF. The pooled data of human trials on coculture demonstrate a statistically significant improvement in blastomere number, implantation rates, and clinical and ongoing pregnancy rates.
Kattal
Namita
N
Department of Obstetrics and Gynecology, Albert Einstein Medical Center, Philadelphia, Pennsylvania, USA. kattaln@einstein.edu
Cohen
Jerry
J
Barmat
Larry I
LI
D018920:Coculture Techniques / Q000706:statistics & numerical data*; D046149:Embryo Culture Techniques / Q000706:statistics & numerical data*; D010064:Embryo Implantation; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D006801:Humans; D007246:Infertility / Q000453:epidemiology* / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012042:Registries; D016896:Treatment Outcome