Endometrial Co culture

A new horizon in ART treatment:

Endometrial co-culture is a new tool in ART treatment for patient who have previous consecutive ART trials and unable to become pregnant. This new technique is currently being used for the first time in Turkey in Memorial Hospital.

Failure in ART treatment can be due to genetic factors, intrauterine factors, hormonal disorders or uterine anomalies.

Endometrial co culture can be explained as artificial uterine environment in vitro and can be a new hope for patients whose previous treatments were unsuccessful due to slow or poor quality embryo development. On the 21st day of the menstrual cycle a small tissue sample is taken from the endometrial tissue (inner cell layer of the uterus) and sent to the ART laboratory. From this small sample an artificial uterine tissue is generated under laboratory conditions and embryos are grown in this tissue culture. Since the tissue is taken from the same woman undergoing ART treatment contamination (hepatitis, HIV infection etc.) risk is minimum. Endometrial cell lines are promoting the growth and further development of the embryos. Co culture fluids are rich in proteins and embryo development factors and support embryo development with growth nutritional factors. The antioxidant developed in the culture environment remove the toxic material around the embryos.

Endometrial co culture also contributes the normal embryo development by releasing growth factors as LIF, IGF, Gm-CSF, TGFa, ILa. Cytokines and growth factors helps not only the interaction between the embryo and the feeder cells but the growth of a good quality embryo as well. Embryos show a dynamic change from the fertilization period to the blastocyst stage, which is considered as the ultimate stage for the time being, needs supportive elements as in in vivo conditions. Under in vivo conditions this development takes place during the transfer of the embryos from fallopian tubes to uterus, and called the implantation period. Since our current knowledge on growth factors and intramolecular changes are very limited, synthetic culture media, which is commonly used for all ART treatments, only mimics these dynamic changes and the embryo development with these media is not yet optimal. In co-culture supported environment, the interaction between the embryo and the endometrial tissue develops as in in vivo conditions and the signals between the embryo and the endometrium causes the release of the growth factors. The unwanted toxic releases of the embryos are also discarded by the the endometrial cells.

Since all the above mentioned factors are very limited in the ready to use synthetic culture media, previous failure of ART treatments when combined with co culture treatment is a very useful alternative to routine ART laboratory workup.

The preparation of the endometrial co culture requires intensive labor, well educated personnel on the subject and well developed technical set up. In Memorial Hospital, Biologist Semra Sertyel is conducting this work.

ART combined with endometrial co culture treatment is being successfully used in Memorial Hospital and within the group of patient who have 2 to 10 times previous failure in ART %35 pregnancy rate achieved over a hundred patients until now. We therefore think that this new treatment can be success fully used for this group of patients

Preparation of endometrial co-culture.

Embryos developing in endometrial co culture.