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Human Reproduction, Vol. 11, No. 11, pp. 2429-2433, 1996
© 1996 European Society of Human Reproduction and Embryology

research-article

Infertility: Beneficial aspects of co-culture with assisted hatching when applied to multiple-failure in-vitro fertilization patients

K.E. Wiemer1,5, J. Garrisi2,3, N. Steuerwald1, M. Alikani2,3, A.M. Reing2,3, T.A. Ferrara2,3, N. Noyes2,4 and J. Cohen2,3

1Institute for Assisted Reproduction 1918 Randolph Road, Charlotte, NC 28207 2The Center for Reproductive Medicine and Infertility, Department of Obstetrics and Gynecology, New York Hospital - Cornell University Medical Center New York, NY 10021, USA 3Present address. Institute for Reproductive Medicine and Science 101 Old Shorthills Road, Suite 405, West Orange, NJ 07052, USA 4Present address: New York University, Department of Obstetrics and Gynecology 317 East 34th Street, 4th Floor, New York, NY 10021, USA

Correspondence: 5To whom correspondence should be addressed

A study was conducted on patients who had attempted and failed previous in-vitro fertilization (IVF) procedures an average of 3.8 times following the application of assisted hatching with conventional culture systems. The aim of this investigation was to determine if addition of co-culture methodologies could reduce embryonic abnormalities and thus improve the prognosis for pregnancy. The study population consisted of 123 patients, subdivided into three patient categories. Previous IVF results from conventional culture were used to evaluate any potential benefits derived from the present co-culture application. Following co-culture, the rate of blastomere development was increased and the rate of fragmentation decreased. An increased rate of blastomere development was most noticeable in the patients aged ≤39 years with no male factor as well as the intracytoplasmic sperm injection (ICSI) subgroup. Similarly, the rate of fragmentation was significantly reduced in the aforementioned subgroups. The most pronounced impact of co-culture was on pregnancy and implantation rates. The overall clinical and ongoing pregnancy rates were 38% (47/123) and 36% (44/123) respectively. The corresponding implantation rate was 17% (72/412) as shown by embryonic cardiac activity. The ongoing pregnancy rates in the ≤39 years no male factor, ≥40 years no male factor and ICSI no age limit patient subgroups were 41% (21/51), 30% (8/27) and 33% (15/45) respectively. The results indicate that addition of co-culture to the IVF procedure for poor-prognosis patients may be advisable.

Key words: assisted hatching/co-culture/implantation/pregnancy


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