Top Quality Embryos Go With The Flow

Ever since the first so-called “test-tube” babies were born, fertility experts have been searching for the best way to culture fertilized eggs outside a woman’s womb.

A new device that mimics the movements inside the womb may help produce better quality embryos.

Normally, nutrient-rich fluid washes over the embryo through muscle contractions within the fallopian tubes.

To copy that in the laboratory, University of Michigan researchers created a culture system that moves pins up and down to send pulses of medium washing over an embryo.

The researchers tested the new system versus standard, static embryo culturing using 315 embryos from 25 women undergoing in vitro fertilization (IVF).

They found the new system slightly boosted the number of embryos graded as top-quality and greatly improved the chances of embryos becoming good quality, reported Michigan’s Gary Smith, Ph.D, Professor, of Obstetrics and Gynecology, at the European Society of Human Reproduction and Embryology annual meeting in Stockholm, Sweden, this month.

He expects the new system to translate into better pregnancy rates, and is tracking that now.

Another important approach to improve the success rate of IVF is to optimize the laboratory conditions for early embryos.

At Weill-Cornell, Zev Rosenwaks, MD and colleagues have developed a method to co-culture embryos with certain helper cells to enhance the development of fertilized eggs and improve embryo quality.

“Endometrial co-culture is a laboratory method that utilizes the mother’s own uterine lining cells to enhance embryo quality,” says Dr. Rosenwaks.

Simply stated, in a separate menstrual cycle 1 to 2 months before undergoing an IVF procedure, the woman undergoes a biopsy of her endometrial lining 7 to 10 days after ovulation.

The cells are separated, grown in the laboratory, and frozen, later to be thawed during the subsequent IVF cycle.

After her eggs are fertilized through IVF, the embryos are grown on top of the mother’s extracted cells.

“This provides a better environment for the embryos, especially for couples who have exhibited poor embryo quality in previous IVF cycles,” he says.

Co-culture is usually reserved for use in “poor prognosis” patients, particularly when other cycles have failed because of slow growth of the embryo.

“This method is not a cure for age-related IVF failures, but in properly selected couples, it has significantly improved embryo quality,” says Dr. Rosenwaks.

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