The use of autologous endometrial co-culture (AECC) improves outcome in young poor responders with multiple failed IVF cycles

Abstract

Young women with multiple failed in vitro fertilization (IVF) attempts are often given a poor prognosis for success. The aim of this study is to analyze the effectiveness of AECC in improving pregnancy rates in young patients (<35) with multiple failed IVF cycles (>2) and proven poor response (<5 oocytes retrieved). Retrospective case control 120 patients were included in the study. 23 patients utilized AECC (cases) and 97 patients utilized traditional culture media (controls). Controls were matched for age, cycle response and ovarian reserve testing. All patients had < 5 oocytes retrieved in previous cycles. Patients undergoing AECC underwent luteal biopsy (5-12 days after LH surge) prior to the treatment cycle, with glandular (G) and stromal (S) endometrial cells isolated by enzymatic digestion and separated based on differential sedimentation rate. These cells were cryopreserved, then plated as a 50%/50% combination of G and S cells prior to embryo exposure. Patients utilizing AECC had all of their embryos grown on AECC until embryo transfer (ET). All patients underwent a day 3 ET. Paired t tests and Chi-square test were used in analysis. P<0.05 was considered statistically significant. Results are shown in table 1. Patients were similar in age and response. In the AECC group, more embryos developed and progressed to transfer. The AECC group also showed improved clinical pregnancy rates.Tabled 1AECC n = 23No AECC n = 97P valueAge33.1 ± 1.833.4 ± 2.5NSPrevious failed cycles4.3 ± 2.53.1 ± 1.30.042Oocytes4.1 ± 0.93.8 ± 1.0NSMature oocytes3.4 ± 1.13.4 ± 1.2NSFertilized 2PN2.7 ± 0.952.5 ± 1.2NSEmbryos progressed to ET*91%80%0.02Implantation rate26.1%14.2%NSClinical pregnancy43.5%21.7%0.03Table 1. *ET (Embryo transfer) Open table in a new tab Table 1. *ET (Embryo transfer) Utilization of AECC in young IVF patients with prior poor response and multiple failed IVF cycles appears to improve pregnancy outcome. A prospective randomized controlled trial is currently ongoing to evaluate this finding.