EFFECT OF CO-INCUBATION OF SPERMATOZOA WITH HUMAN ENDOMETRIAL CELLS ON ASSISTED REPRODUCTION OUTCOMES

Abstract

Тo evaluate the effect of the co-incubation of spermatozoa with human endometrial cells prior ICSI on the assisted reproduction outcomes (fertilisation rate, proportion of high quality embryos, implantation rate and live birth rate) in couples with unexplained infertility. Prospective. 110 couples fulfilled the inclusion criteria of unexplained infertility and males with normozoospermia or teratozoospermia. All patients have signed written informed consent. Couples were randomly allocated to study group (n=55) and control group (n=55). After liquefaction all fresh semen samples were washed and were subjected to swim up. Semen samples from the study group were co-incubated for 2 hours with endometrial cell culture, obtained from their partners’ endometrial biopsy. All patients underwent standard ICSI protocol. Embryo transfer was performed in 42 couples of the control group and on 40 couples in the co-incubation group. Main outcomes were fertilisation rate, proportion of high quality embryos, implantation rate and live birth rate. Statistical analyses were performed using SPSS v21. P>0.005 was considered significant. The study group and the control group were comparable in terms of female age, male age, count of unsuccessful IVF cycles, oocyte count and oocyte quality. There were no significant differences in the fertilisation rate (78±9% vs. 80±8%, p>0.05) and the proportion of high quality embryos (62±12% vs. 65±9%, p>0.05) between the co-incubation group and the control group. However, the implantation rate after sperm co-incubation with human endometrial cells was significantly higher when compared to the control group (46% vs. 33%, p<0.05). The live birth rate of the successfully implanted embryos was also significantly higher in the co-incubation group in comparison to the control group (95% vs. 40%, p=0.003). Co-incubation of spermatozoa with endometrial cell culture has no effect on fertilisation rate and proportion of high quality embryos, but leads to higher implantation rate and live birth rate in comparison to conventionally prepared semen for ICSI. These results indicate that couples with unexplained infertility can benefit from sperm co-incubation with endometrial cells before performing ICSI.