Autologous Endometrial Coculture

Autologous Endometrial Co-culture is a method of embryo transplanting, it is considered to be a modern method to help women who have undergone several failed trials during IVF or in cases of fetal weakness and inability to survive and complete pregnancy. This technique is based on a biopsy of the wife's endometrium, processed and prepared, and then the fertilized eggs are placed on it to begin divisions before transferring to the uterus.

This method provides a better environment for fertilized eggs for growth and division, which improves the quality of embryos and stimulates their growth at higher rates than normal, but because of their high cost, they are not widely spread.

The method of autologous endometrial co-culture is not valid for all women, but it is recommended for specific cases because of the following reasons:

• Low quality and embryo weakness.
• Unsuccessful pregnancy after several IVF cycles.

One or both of the spouses undergo some of the previous tests to begin the procedure for Autologous Endometrial Co-culture. These include the following:

• AMH test (Anti-Müllerian Hormone); to assess ovarian function and the ability to produce mature eggs for fertilization.
• FSH test (Follicle-stimulating hormone); to assess the wife's ovaries disorders and testicular problems in the husband.
• AFC test (Antral follicle count); to assess the number of primary eggs in the ovary (ovarian reserves).
• Ultrasound examination of the uterus to ensure the integrity of the inner lining of the uterus.
• Examination of the uterus and vagina through the endoscope by inserting it through the vagina.
• Examination of the husband's sperm to check their number, size and shape.

Autologous endometrial co-culture may involve some complications, including:

• High chance of viral infection of the fetus.
• High cost of this technique.
• It requires a lot of steps inside the lab which makes it boring for fertilization technicians.

Autologous endometrial includes the following steps:

1. Take a biopsy from the endometrium, send it to the laboratory for processing as necessary and then freeze until used after obtaining eggs and sperms from husband and wife.
2. Give the wife a set of stimulating injections for about 10 to 12 days starting from the second or third day of the menstrual cycle, with careful monitoring of the eggs through sonar or ultrasound, followed by different visits to the gynecologist and obstetrician to follow the ovulation and measure the size and shape of the stimulated eggs.
3. Giving an HCG injection to the wife to release the eggs from the follicles.
4. Extraction of the eggs after 34 to 36 hours of the HCG injection, the wife is given a sedative to relieve pain and, in some cases, performed under general anesthesia, by inserting a very fine suction needle through the vagina to the ovary.
5. Take a sample of the husband's semen.
6. Fertilize the eggs by leaving them in optimal conditions with sperm and defrosting the frozen endometrium.
7. Transfer the fertilized eggs about a day later and place them on the endometrium taken from the wife.
8. Monitor the development of fertilized eggs until a certain level of divisions are reached and then transferred to the uterus.

After autologous endometrial, the wife is asked to wait approximately two weeks - depending on the age of the embryo when it is transferred - to have a pregnancy test (blood test not home test), as the results often appear after this period.

The wife can practice her normal life after IVF, but one of the tips for the success of IVF is to make sure to avoid stressful activities and try to rest as much as possible, and abstain from sexual intercourse for about a week, also it is preferred to drink enough amounts of water.

Autologous endometrial is a method that does not involve many risks and has high rates of successful pregnancy in addition to the high-quality embryos due to its growth in laboratory conditions that largely mimic normal uterine conditions.