The use of human cumulous cells co-culture has proved advantageous in many ways which might prove crucial in achieving higher implantation rates in an SMP. M. Benkhalifa, D. Daphnis, M. Solanou, M. Tsouroupaki and I. Giakoumakis

1. Cumulous cells co-culture and surrogacy (Marrakech May 2013)
In the XIth Annual Meeting of Mediterranean Society for Reproductive Medicine on Friday, May 3, 2013 in
Marrakech our team presented our work entitled “Clinical outcome improvement after autologous embryo-cumulus
cells co culture in a Surrogacy Motherhood”
M. Benkhalifa, D. Daphnis, M. Solanou, M. Tsouroupaki and I. Giakoumakis
Background: Implantation failure following embryo transfer during an IVF cycle is a common cause of low
pregnancy rates. The need of high success rates in a surrogacy motherhood program (SMP) is deemed essential
due to the complexity of the treatment. Human embryo co-culture with different feeder systems has been found to
increase implantation rate. The use of human cumulous cell co-culture has proved advantageous in many ways
which might prove crucial in achieving higher implantation and subsequently pregnancy rates in an SMP.
Objective: We evaluated the effect of autologous embryo-cumulous cells co-culture on the outcome of a surrogate
motherhood program (SMP).
Materials and Methods: Eighteen commissioning couples (group A; mean age: 35.8) had embryo transfer with
embryos co-cultured in sequential media (SAGE, Biocare; Italy) alongside with fresh cumuli cells. Another group of
twenty two couples (group B; mean age 36.4) had embryo transfer with embryos cultured in sequential media only.
In both groups ICSI was performed and the embryo transfer was performed on day 5. All commissioning female
partners underwent ovarian stimulation using the short antagonist protocol.
Results: In Group A a total of eighteen fresh ET’s were carried out which showed a 38.8% (7/18) clinical
pregnancy rate. In Group B the clinical pregnancy rate was 31.8% (7/22) for Group B. The difference in pregnancy
rates between the groups was found to be statistically significant when the Chi square test (P<0.05) was
performed.
Conclusions: Culture conditions have a detrimental effect in the early embryo development. The use of a
cumulous co-culture system revealed better quality embryos for transfer which was supported by a statistically
significant increase in pregnancy rate. It is imperative to increase pregnancy rates in a SMP which, as shown, can
be achieved by adding cumuli cells in a sequential media. The technique is fairly simple and cost-effective,
however a larger, randomized study should be undertaken to obtain a better perspective and understanding.