Mild Stimulation ved IVF

januar 21, 2018

Mild stimulation ved reagensglasbehandling (IVF) er udviklet på baggrund af de seneste års behandling af ufrivilligt barnløse. Man har haft den opfattelse af jo flere æg man kunne hente ud jo bedre blev resultatet af behandlingen.

Sagt på en anden måde jo flere æg jo flere graviditeter.

Det har nu vist sig at dette ikke altid er rigtigt. Flere videnskabelige undersøgelser har vist at selv ved meget mild stimulation, hvor man kun får få æg ud, har man flotte resultater og mange gravide.

Årsagne til dette er at slev stimulationsbehandlingen kan påvirke kvaliteten af æggene og også slimhinden i livmoderen så hvert æg man får faktisk har en bedre mulighed for at lave en graviditet ved Mild Stimulation sameholdt med konventionel stimulation med mange æg.

Bivirkningerne er også reduceret ved mild stimulation o omkostningerne mindre ligesom tiden kvinden skal bruge på behandlingen.

Copenhagen Fertility Center tilbyder som den eneste i Danmark denne behandling rutinemæssigt til vores patienter.

 

Du kan læse mere her: Mild Stimulation

 

copenhagenfertilitybaby

 

 

Reklamer

Mild IVF, bedre patient sikkerhed og billiger for samfundet.

august 9, 2017

DSC_1559 - Kopi.JPG

 

Mild IVF: Minimal stimulation ved IVF behandling

Copenhagen fertility Center  tilbyder nu som rutine behandling ikke alene almindeligt IVF men også mild stimulations IVF også kaldet Japaner modellen. Denne metode er ny og sænker omkostningerne ved IVF behandlingen betydelig både for patienterne med også for medicin udgifterne, som i Danmark betales af Staten

Vi har på Copenhagen Fertility Center arbejdet med denne metode igennem nogle år i sammen med udenlandske forskere og kan nu i dag konstaterer, er at denne metode er lige så effektiv som almindeligt IVF.

Aktuelle studier fra Michigan State og Standford Universitet, Epidemiologiske afdeling viser at høje doser follikel stimulerende hormon ikke giver bedre resultater. Et højt antal æg ved almindeligt IVF behandling giver ikke bedre resultater tværtimod. (ref 1)

Mild IVF anvender meget små mængder hormoner og det meste af medicinen tager patienten peroralt, d.v.s. kun få injektioner i en hel behandling. Dette medfører en mere naturlig stimulation og som sagt mindre antal æg, men af bedre kvalitet. Ligeledes undgår man i stor udstrækning også de svære bivirkninger ved almindelig IVF, nemlig oversimulation og smertefulde æg udtagninger,

Gnnem vores forskning på Copenhagen Fertility Center (ref 2.) er behandlingen nu optimeret til også at fungere hos kvinder over 35-40 års alderen. Selv kvinder med ”low responce ”eller lavt AMH har gode resultater med Mild IVF.

Mild IVF er designet til at rekruttere få modne æg af god kvalitet, hvorfor man undgår ovariel hyperstimulation og reducerer antallet af injektioner betydeligt. Mild IVF øger kvaliteten af æggene betydeligt selv hos ældre kvinder og kvinder med dårlig ægkvalitet ved almindelig IVF.

Mild IVF er derfor et godt alternativ til almindelig IVF, betydeligt mere simpelt og meget billigere.

Sådan foregår behandlingen:

På dag 3 i menstruationscyklus bliver du skannet og er livmoderslimhinden i orden og man ikke finder cyster på æggestokkene starter du med 2 tabletter Tamoxifen eller Clomifen dagligt. Denne behandling fortsætter indtil den ægløsende sprøjte og stopper ikke før. Hver 2 dag får du ligeledes på 3,5,7 dagen i stimulationen også FSH 150 iu som injektion. Efter 9 dages stimulation kommer du til en skanning og her fastlægges ægudtagningen. Her får du en injektion med Ovitrelle og 32 timer sener taget æggene ud.

Ægudtagningen.

Copenhagen Fertility Center har udviklet i samarbejde med specialister i lokalbedøvelse en ny og meget skånsom ægudtagnings teknik til Mild IVF. Da der ikke er mange follikler,er det muligt med en meget tyndere nål og med en speciel bedøvelse at suge æggen ud fra æggestokkene med mindre eller ofte ingen smerter. Der er således sjældent behov for at ligge efter ægudtagningen og patienterne kan gå på arbejde med det samme uden at have en sygedag.

Alt efter hvilken behandling man har fastlagt lægges æggen op som 4 celler på dag 2, som blastocyster på dag 5 efter ægudtagningen. Blastocuster kan også fryse fra flere behandlinger og så lægges op ved en senere lejlighed.

Denne behandling anvender således ikke dyr nedregulerings medicin, som ofte kan give bivirkninger, ligesom den stimulerende medicin er reduceret og derfor spare man mange penge.

En af bivirkningerne ved IVF behandling er ofte at livmoderslimhinden ikke når at udvikle sig ordentligt. Ved mange forsøg uden resultater tilbyder vi derfor Mild IVF, hvor blastocysterne lægges i fryseren ved Vitrifikations metoden. Herefter kan de lægges op i en naturlig cyklus med bedre resultater.

Ældre kvinder med lav AMH.

For ældre kvinder med dårlig prognose har Mild IVF også en indikation. Ofte har disse kvinder gennemgået flere IVF behandlinger med høje doser hormoner uden at få gode æg ud, eller bare meget få dårlige æg. Netop Mild IVF kan have en bedre påvirkning, da man her anvender meget lave doser og får få men ofte bedre kvalitet æg ud.

Mindre spild af æg.

Mild stimulation løser også et andet stort problem. Mere end 90 % af alle de æg som man udtager ved IVF anvendes aldrig og er derfor til spild. Enten er de dårlige, deler sig ikke, er ikke gode nok til frys eller bliver aldrig brugt. Dette store spild undgår man ved at anvende Mild IVF hvor en betydeligt større del af æggene ender med en graviditet end ved almindelig IVF. (Ref.3.).

Prisen ved Mild stimulation.

Der er flere forhold som gør denne behandling billigere. Selve prisen på klinikken er 13.000 danske kroner for behandlingen og oplægning af æggene. Udover dette er udgifterne til medicinen meget begrænset i forhold til almindeligt IVF. Tiden man anvender på klinikken er kortere og bivirkningerne betydeligt mindre. Ligeledes behøver man ikke at tage fri for arbejde ved skanninger eller ægudtagningen.

Hvorfor tilbyder så ikke flere denne behandling?

Mild IVF er ikke nogen let behandling i klinikken. Man kan ikke udskyde en ægudtagning og ultralydsskanningerne skal foretages af erfarende læger. Selve laboratorie arbejdet er ligesom ved almindelig IVF, men mulighederne for at lave total frys og samle blastocyster op er et reelt tilbud til enkelte vanskelige patienter.

Copenhagen Fertility Center har i mange år deltaget i et forsknings og udviklings samarbejde med andre fertilitetskliniker om netop MILD IVF og er den klinik i Europa, der har foretaget flest MILD IVF behandlinger indtil nu. Du kan læse mere om vores forskning i Ref. 4.

Ref 1: http://www.fertstert.org/article/S0015-0282(15)01663-5/fulltext

Ref.2: https://www.omicsonline.org/peer-reviewed/low-ovarian-stimulation-using-tamoxifenfsh-compared-to-conventional-ivf-a-cohort-comparative-study-in-conventional-ivf-treatments-12308.html

Ref.3: http://www.fertstert.org/article/S0015-0282(17)30257-1/fulltext

Ref.4: http://www.copenhagenfertilitycenter.com/uploads/aarsrapport2016.pdf

 

Mobil telefoner ødelægger mænds sæd

juni 10, 2014

Mænds sædkvalitet kan ødelægges af mobil telefoner i lommerne.

 

En ny undersøgelse fra Execter Universitet viser at en mobil telefon i lommen forringer mænds sædkvalitet.

Det kan derfor være en god ide at advare mænd at advare mænd mod at lægge telefonen i bukselommen.

 

Læs mere her; Copenhagen Fertility Center

Big Pharma compagnies or small, where are we going ?

maj 25, 2014

A great meeting in Geneva.

Svend Lindenberg.

Copenhagen Fertility Clinic at Work in Geneve

Copenhagen Fertility Clinic at Work in Geneve

The global market with drug manufacturers has develop to such an extent that many small drug manufacturers no longer make money on drug development or cannot afford to be a part of this. Thus we see that the final cost of developing a product has increased over the years and is now after assessment by Forbes at $ 5 billion.

Ref: Forbes

Such a project was discussed at the meeting in Geneva this Friday.

The company Anecova has developed a culture dish for in vitro fertilization, taking advantage of the woman’s own womb as an incubator and cultivation unit. Fertility treatment has for 30 years been characterized by more and more advanced culture media and techniques with the addition of hormones, chemicals and changes in the air around the eggs. All these initiatives have been taken to improve the primitive artificial environment which eggs are exposed to in vitro. This has also increased the cost of treatment to patients. Beyond this, one had to give patients more and more drugs to get as many eggs as possible in order to get this artificial system to work as more than 90% of such eggs never will be used for creating off springs. This manipulation of the natural environment by changing the in vitro culture with chemicals and hormones has given patients and doctors the concern: “Does this harm the children?” Few scientific studies have shown an impact on the eggs when high hormone levels for hyper stimulation have been used or hormones added to the culture media. Until now, this has not been shown to be of any harm to the children however.

Further to this, the pharma industry now increases their sales by selling product to overcome the adverse effect of the products already on the marked.

The new strategies for fertility treatment is to try to avoid such damage to the egg by simply think smarter.

Thus, we must say that Anecova are a small company with a good idea. Instead of following on the heels of the others in the pharmaceutical industry and develop even more advanced hormone treatments for women and eggs , they tried to put it away and take advantage of the woman’s own body fluids and uterus. The lurking simply nature and uses it instead by creating a non-artificial nature for the eggs. This is also seen in big farma now. Bristol- Myers, under their former boss Elliott Sigal studied immune system of the human body and produce new cancer drugs by using nature itself. Anecova has developed a small chamber that can contain both egg and sperm and then grow eggs in the uterus without the addition of media and artificial environment for routine test-tube baby treatment also called IVF.

This technology can now produce fine embryos and pregnancies and at the same time avoids probably all the harmful environmental impacts of the artificial media. Likewise, you do not need as many eggs, which means you can use a very mild pre-treatment of women and thereby avoid the dreaded side effects of ovarian hyper stimulation syndrome.

Anecova is now in the final stage of this work in collaboration with several international clinics and researchers; Copenhagen Fertility Center is also included.

Read more here: www.anecova.com

Nye Kliniske Retningslinjer for Polycystiske Ovarie Patienter (PCO)

maj 19, 2014

Sundhedsstyrelsen har lige udgivet et sæt gode og retningslinjer til landets patienter vedrørende udredning og risikovurdering af patienter med PCO.

Dette medfører forhåbentligt en mere ens behandling af disse kvinder. Flot arbejde af Sundhedsstyrelsen.

 

Du kan læse mere her: Copenhagen Fertility Center

Hvad bør jeg vide inden jeg går i Fertilitets behandling.

januar 22, 2014

På Copenhagen Fertility Center har vi samlet de oplysninger, som ofte giver anledning til misforståelser i behandlingen.

Her får du svar på hvilke behandler der er, hvilke risici og hvordan samarbejdet mellem fertilitetsklinikken og patienten foregår.

På denne måde undgår du de hyppigste problemer i samarbejdet med fertilitetsklinikken.

Med udgivelsen af “Hvad bør jeg vide inden jeg går i Fertilitets behandling ” har vi på Copenhagen Fertility Center prøvet at samle op på misforståelser og faldgrupper som:

Hvem sørger for henvisninger ?

Hvem har ansvaret for tilskuds ansøgninger ?

Hvordan forholder jeg mig til når jeg er enlig, men vil have et barn ?

Hvordan foregår det med åbne og lukkede donorer ?

Hvad gør jeg, hvis jeg selv kommer med en donor ?

Og mange andre sprøgsmål.

Læs mere her om dette på Copenhagen Fertility Centers hjemmeside

Report from an ISO agent from another planet looking at quality systems in the Health Sector

januar 17, 2014

Report from an ISO agent from another planet looking at quality systems in the Health Sector.

Suggestion for improvement:

copenhagenfertilitycenter

This figure illustrates the few but important elements in ISO 9001.

Many of these elements have been implemented in the Health System. However, only in small isolated structures.

Controlled document systems: There are 5 mill people in Denmark but more than 10 different non corresponding document systems for patients in the hospitals and clinics.

Balances score card: Not existing

External audits: Very few auditors trained properly. However many systems implemented without proper management prepared.

Quality tools: No common agreement in Denmark.

Corrective and Preventive action: Separated in between political and professional sectors.

Strategic planning: Fragmented in several layers without a joint effort or perspective.

Management review: Mostly done for the public and journalists.

Suggestion for improvement: Start educate and train the so-called “experts” before letting them teach other in quality control systems. Preferable teach personnel with a professional experience in real life.

60 % increase in pregnancy rate is soon possible.

januar 13, 2014

Billede

A chines research Group has together with scientist at Harvard University developed a new method for selecting the best egg before embryo transfer in IVF.

For many years it has been possible to select the polar body of an developing embryo right after fertilisation for test. However the contend of DNA is very little, Thus proper genetic test has been unreliable.

This research team has developed a new and much more sensitive type of amplification, which has been named “multiple annealing and looping-based amplification cycles (MALBAC). By applying this technology to developing human embryos they were able to sequencing the whole genome in the polar body and herby detect all maternal genomic errors, before the embryo should be selected for embryo transfer.

This technology thus deselects bad embryos due to their chromosome aberrations which count for up to 80% of all problems with human embryos, specifically in the old patients.

Thereby all other selections procedures such as the Embryo scope, metabolic etc. can be set aside as this technology by far would be much more efficient.

Read more here.

Copenhagen Fertility Center

Reference: Genome Analyses of Single Human Oocytes

Hou, Yu; Fan, Wei; Yan, Liying; Li, Rong; Lian, Ying; Huang, Jin; Li, Jinsen; Xu, Liya; Tang, Fuchou; Xie, X. Sunney; Qiao, Jie  

Cell doi:10.1016/j.cell.2013.11.040 (volume 155 issue 7 pp.1492 – 1506)

 http://www.nature.com/news/non-invasive-method-devised-to-sequence-dna-of-human-eggs-1.14412 http://www.cell.com/retrieve/pii/S0092867413015262

 

 

 

 

 

Co culture in IVF

januar 6, 2014

Copenhagen Fertility Center priming and endometrial co culture for in vitro fertilization.
New research results; back to nature for the embryos.

By Svend Lindenberg, professor dr. med. Copenhagen Fertility Center, Section for Reproduction and Research

Read more here about co culture on Copenhagen Fertility Center .

Copenhagen Fertility Center started in 1981 doing endometrial monolayer cultures and at the same time combined this with culture of human embryos. This technology was already used in animal breeding and was found to produce better embryos and higher implantations results.
However due to the complexity of this technology it was abandoned in human IVF for many years.

The technology was difficult due to several reasons:

1) We believed at that time, that an endometrial biopsy might jeopardy the later implantation. Therefore the endometrial culture had to be established form frozen thawn endometrial cell was taken earlier than the actual treatment cycle.
2) The culture medium used for embryo culture should be conditioned for a longer time on these endometrial cultures before use, due to high content of endotoxins in these days.

Today Copenhagen Fertility Center has shown, that endometrial priming (and taking biopsies) in the actual treatment cycle is only enhancing the chance for pregnancy and we can now produce endometrial cell culture directly without freezing of the cells. This has been shown in our laboratories and is now used for patient treatments. The first pregnancies in difficult patients as repeated implantation failures patients are now recorded.

In a way, we are now putting a bit of nature into the laboratory by mimicking the uterus in the lab. The co culture of the women’s own endometrial cells and her embryos helps the embryo to develop normally. We are actually able to see this communication between the embryo and the endometrial cell during the culture period in the lab.

We are now teaching laboratories in Europe this new fast endometrial embryo co culture system and hope this will benefit more patients. The problem for many IVF lab´s is that they are not trained in regular tissue culture systems.

Therefore, the procedure now include the following for the patient.
1) Endometrial priming and biopsy on day 5 in the treatment cycle.
2) Co culture of the endometrial monolayer epithelial cell with the embryos
3) Culture up to blastocyst stage.
All of these three technologies are known to increase the pregnancy rate in older women and in difficult IVF cases. However combining this is now possible in a simple and efficient way. This is the new entity of Copenhagen Fertility Research Team.

References:
Referencer
Lindenberg S, Hyttel P, Sjogren A. A comparative study of attachment of human, bovine, and mouse blastocysts to uterine epithelial monolayer. Hum Reprod 1989; 4:446-456.
Embryologic outcome and secretome profile of implanted blastocysts obtained after coculture in human endometrial epithelial cells versus the sequential system
Francisco Dominguez, Blanca Gadea, Amparo Mercader, Francisco J. Esteban, Antonio Pellicer, Carlos Simón
Fertility and sterility 1 February 2010 (volume 93 issue 3 Pages 774-782.e1 DOI: 10.1016/j.fertnstert.2008.10.019)
Beneficial effect of autologous endometrial cell coculture in patients with repeated implantation failure Victoria Eyheremendy, Fernanda G.E. Raffo, Mercedes Papayannis, Julia Barnes, Cintia Granados, Jorge Blaquier
Fertility and sterility 1 February 2010 (volume 93 issue 3 Pages 769-773 DOI: 10.1016/j.fertnstert.2008.10.060)
Bongso A, Ng SC, Fong C-Y, Ratman S. Co cultures: a lead in embryo quality improvement for assisted reproduction. Fertil Steril. 1991;67:120–122
Barmat LI, Liu HC, Spandorfer SD, Veek l, Damario M, Rosenwaks Z. Human preembryo development on autologous endometrial coculture versus conventional medium. Fertil Steril. 1998;70:1109–1113
Menezo Y, Hazout A, Dumont M, Herbaut A, Nicollet B. Coculture of embryos on Vero cells and transfer of blastocysts in human. Hum Reprod. 1992;7(Suppl 1):101–106
Jayot S, Parneix I, Verdaguer S. Coculture of embryos on homologous endometrial cells in patient with repeated failures of implantation. Fertil Steril. 1995;63:109–114
Barmat LI, Liu HC, Spandorfer SD. Autologous endometrial co-culture in patients with repeated failures of implantation after in vitro fertilization-embryo transfer. J Assist Reprod Genet. 1999;16:121–127
Rubio C, Simon C, Mercader A. Clinical experience employing co-culture of human embryos with autologous human endometrial epithelial cells. Hum Reprod. 2000;15(Suppl 6):31–38
Mercader A, Garcia-Velazco J, Escudero E, Remohi J, Pellicer A, Simon C. Clinical experience and perinatal outcome of blastocyst transfer after coculture of human embryos with human endometrial epithelial cells. Fertil Steril. 2003;80:1162–1168
Spandorfer SD, Pascal P, Parks J, Clark R, Veeck L, Davis OK, et al. Autologous endometrial co-culture in patients with IVF failures: outcome of the first 1030 cases. J Reprod Med. 2004;49:463–467
Spandorfer S, Park J, Davis O, Clarke R, Rosenwaks Z. A case controlled study evaluating autologous endometrial coculture (AECC) as an effective tool for young patients (age under 36 years) with multiple failed IVF attempts and diminished ovarian reserve. Fertil Steril. 2007;88(Suppl 1):O-275
Barash A, Dekel N, Fieldust S, Segal Ll, Schechtman E, Garanot I. Local injury to the endometrium doubles the incidence of successful pregnancies in patient undergoing in vitro fertilization. Fertil Steril. 2003;79:1317–1322
Menezo Y, Guerin J, Czyba J. Improvement of early human embryo development in vitro by coculture on monolayers of Vero cells. Biol Reprod. 1990;42:301–306
Nieto F, Watkins W, Lopata A, Baker G, Edgar D. The effect of coculture with autologous cryopreserved endometrial cells on human in vitro fertilization and early embryo morphology: a randomized study. J Assist Reprod Genet. 1996;13:386–389
Simon C, Pellicer A. Interleukin-1 system crosstalk between embryo and endometrium in implantation. Hum Reprod. 1995;10(Suppl 1):11
Spandorfer SD, Barnat LI, Liu HC, Mele C, Veeck L, Rosenwaks Z. Granulocyte macrophage stimulating factor production by autologous endometrial co-culture is associated with outcome for IVF patient with a history of multiple implantation failures. Am J Reprod Immunol. 1998;40:377–381
Spandorfer SD, Neuer A, Liu HC, Bivis L, Clarke R, Veeck L, et al. Interleukin-1 levels in the supernatant of conditioned media of embryos grown in autologous endometrial co-culture: correlation with embryonic development and outcome for patient with a history of multiple implantation failures. Am J Reprod Immunol. 2000;42:6–11
Spandorfer SD, Navarro J, Levy D, Black AQR, Liu HC, Veeck L, et al. Autologous endometrial co-culture in patient with IVF failures: correlation of outcome with leukemia inhibiting factor (LIF) production. Am J Reprod Immunol. 2001;46:375–380
Bendikson K, Park J, Rosenwaks Z, Spandorfer S. Do cytokine levels in the supernatant from conditioned media of embryos grown in autologous endometrial coculture correlate with pregnancy outcomes after in vitro fertilization?. Fertil Steril. 2007;(Supp 1):88;O-152
Barmat LI, Liu HC, Spandorfer SD, Veek L, Damario M, Rosenwaks Z. Importance of the biopsy date in autologous endometrial cocultures for patients with multiple implantation failures. Fertil Steril. 2002;77:1209–1213Arnold JT, Kaufman DG, Seppala M, Lessey BA. Endometrial stromal cells regulate epithelial cell growth in vitro: a new co-culture model. Hum Reprod. 2001;16:836–845
Simon C, Mercader A, Garcia-Velasco J, Nikas G, Moreno C, Remohi J, et al. Coculture of human embryos with autologous human endometrial epithelial cells in patients with implantation failure. J Clin Endocrinol Metab. 1999;84:2638–2646
Mercader A, Garcia-Velasco JA, Escudero E, Remohi J, Pellicer A, Simon C. Clinical experience and perinatal outcome of blastocyst transfer after coculture of human embryos with human endometrial epithelial cells: a 5-year follow-up study. Fertil Steril. 2003;80:1162–1168
Simón C, Gimeno MJ, Mercader A, O’Connor JE, Remohí J, Polan ML, et al. Embryonic regulation of integrins beta 3, alpha 4, and alpha 1 in human endometrial epithelial cells in vitro. J Clin Endocrinol Metab. 1997;82:2607–2616
Simón C, Mercader A, Garcia-Velasco J, Nikas G, Moreno C, Remohí J, et al. Coculture of human embryos with autologous human endometrial epithelial cells in patients with implantation failure. J Clin Endocrinol Metab. 1999;84:2638–2646

december 24, 2013

Nu er vi tæt på naturlig IVF behandling.

Copenhagen Fertility Center har igennem 5 år udviklet og indført lav stimulation og udtagning af få æg til in vitro fertilisations (IVF) behandling og set, at vi på unge patienter har samme resultater eller bedre end ved konventionel IVF. Dette har vi gjort, fordi vi ønsker så få bivirkninger som muligt for kvinden, men også fordi vi har set at æggenes kvalitet bliver bedre ved denne lave stimulation.

Samtidigt har vi arbejdet igennem 30år med co-culture, dvs. dyrkning af kvindens æg sammen med celler fra hendes livmoder slimhinden.  Dette er altså ikke en ny behandling, da vi allerede gjorde dette på Rigshospitalet for 30 år siden.

Hvorfor har man så ikke gjort det tidligere?

En af årsagerne til, at man ikke i IVF laboratorier har taget dette op som en rutine behandling, har været den fejlopfattelse, at man skulle tage livmodercellerne ud i en cyklus inden selve behandlingen for ikke at forstyrre livmoderen i den tid, man lægger ægget op. Så har man skullet fryse livmodercellerne, eller sende dem til laboratorier i f.eks. Frankrig, for at kunne dyrke dem op på det rigtige tidspunkt. Det rigtige tidspunkt var så 1 måned senere. Dette skabte en masse logistiske og administrative problemer, ligesom cellerne ikke havde det så godt. Nu hvor vi med en speciel teknik kan udtage celler  fra livmoderen i den samme måned, som de skal anvendes, uden at forstyrre livmoderen (tværtimod gavner dette implantationen), er sagen en anden.  Ligeledes har Copenhagen Fertility Center erfaring med dyrkning af celler gennem 30 år smat trænet og erfarent personale.

Vi kan nu i et meget sikkert og let administrativt system udtage celler og gøre dem klare uden frysning til brug når æggene udtages 5-10 dage senere.

Kort fortalt gør vi følgende:

På 5. cyklus dag udtager vi en lille prøve fra livmoderslimhinden med et kateter og dyrker disse celler fra prøven i de skåle,  som ægget senere kommer ned i ved IVF behandlingen.

Der foreligger nu tilstrækkeligt med videnskabelige undersøgelser, som viser at dette forbedrer behandlingen og chancerne for kvinder med mange IVF behandlinger og kvinder med mange aborter.

På Copenhagen Fertility Center tilbyder vi som den eneste i Skandinavien denne behandling, idet vi nu har sammensat et team af folk, som kan lave disse cellekulturer.

Vi har derfor sammensat en behandling med lav stimulation, co culture af æggene til blastocyst og tilbagelægning.

  • Fordelen ved dette er:
  • Færre bivirkninger for kvinden.
  • Bedre udvælgelse af bedre æg.
  • Mindre antal tvillinger idet vi kan fryse overskydende blastocyster.

 BilledeEt billed af en co culture af blastocyst og livmoderslimhinden

 

Referencer.

Lindenberg S, Hyttel P, Sjogren A. A comparative study of attachment of human, bovine, and mouse

blastocysts to uterine epithelial monolayer. Hum Reprod 1989; 4:446-456.

Low Ovarian Stimulation Using Tamoxifen/FSH Compared to Conventional IVF: A Cohort Comparative Study in Conventional IVF Treatments Frederikke B Lindenberg1,2, Gitte Juul Almind1 and Svend Lindenberg1* Reprod Sys Sexual Disorders 2013, S5, http://dx.doi.org/10.4172/2161-038X.S5-005

Embryologic outcome and secretome profile of implanted blastocysts obtained after coculture in human endometrial epithelial cells versus the sequential system

Francisco Dominguez, Blanca Gadea, Amparo Mercader, Francisco J. Esteban, Antonio Pellicer, Carlos Simón

Beneficial effect of autologous endometrial cell coculture in patients with repeated implantation failure
Victoria Eyheremendy, Fernanda G.E. Raffo, Mercedes Papayannis, Julia Barnes, Cintia Granados, Jorge Blaquier
Fertility and sterility 1 February 2010 (volume 93 issue 3 Pages 769-773 DOI: 10.1016/j.fertnstert.2008.10.060)

 

 

Bongso A, Ng SC, Fong C-Y, Ratman S. Co cultures: a lead in embryo quality improvement for assisted reproduction. Fertil Steril. 1991;67:120–122

Barmat LI, Liu HC, Spandorfer SD, Veek l, Damario M, Rosenwaks Z. Human preembryo development on autologous endometrial coculture versus conventional medium. Fertil Steril. 1998;70:1109–1113

Menezo Y, Hazout A, Dumont M, Herbaut A, Nicollet B. Coculture of embryos on Vero cells and transfer of blastocysts in human. Hum Reprod. 1992;7(Suppl 1):101–106

Jayot S, Parneix I, Verdaguer S. Coculture of embryos on homologous endometrial cells in patient with repeated failures of implantation. Fertil Steril. 1995;63:109–114

Barmat LI, Liu HC, Spandorfer SD. Autologous endometrial co-culture in patients with repeated failures of implantation after in vitro fertilization-embryo transfer. J Assist Reprod Genet. 1999;16:121–127

Rubio C, Simon C, Mercader A. Clinical experience employing co-culture of human embryos with autologous human endometrial epithelial cells. Hum Reprod. 2000;15(Suppl 6):31–38

Mercader A, Garcia-Velazco J, Escudero E, Remohi J, Pellicer A, Simon C. Clinical experience and perinatal outcome of blastocyst transfer after coculture of human embryos with human endometrial epithelial cells. Fertil Steril. 2003;80:1162–1168

Spandorfer SD, Pascal P, Parks J, Clark R, Veeck L, Davis OK, et al. Autologous endometrial co-culture in patients with IVF failures: outcome of the first 1030 cases. J Reprod Med. 2004;49:463–467

Spandorfer S, Park J, Davis O, Clarke R, Rosenwaks Z. A case controlled study evaluating autologous endometrial coculture (AECC) as an effective tool for young patients (age<36 years) with multiple failed IVF attempts and diminished ovarian reserve. Fertil Steril. 2007;88(Suppl 1):O-275

Barash A, Dekel N, Fieldust S, Segal Ll, Schechtman E, Garanot I. Local injury to the endometrium doubles the incidence of successful pregnancies in patient undergoing in vitro fertilization. Fertil Steril. 2003;79:1317–1322

Menezo Y, Guerin J, Czyba J. Improvement of early human embryo development in vitro by coculture on monolayers of Vero cells. Biol Reprod. 1990;42:301–306

Nieto F, Watkins W, Lopata A, Baker G, Edgar D. The effect of coculture with autologous cryopreserved endometrial cells on human in vitro fertilization and early embryo morphology: a randomized study. J Assist Reprod Genet. 1996;13:386–389

Simon C, Pellicer A. Interleukin-1 system crosstalk between embryo and endometrium in implantation. Hum Reprod. 1995;10(Suppl 1):11

Spandorfer SD, Barnat LI, Liu HC, Mele C, Veeck L, Rosenwaks Z. Granulocyte macrophage stimulating factor production by autologous endometrial co-culture is associated with outcome for IVF patient with a history of multiple implantation failures. Am J Reprod Immunol. 1998;40:377–381

Spandorfer SD, Neuer A, Liu HC, Bivis L, Clarke R, Veeck L, et al. Interleukin-1 levels in the supernatant of conditioned media of embryos grown in autologous endometrial co-culture: correlation with embryonic development and outcome for patient with a history of multiple implantation failures. Am J Reprod Immunol. 2000;42:6–11

Spandorfer SD, Navarro J, Levy D, Black AQR, Liu HC, Veeck L, et al. Autologous endometrial co-culture in patient with IVF failures: correlation of outcome with leukemia inhibiting factor (LIF) production. Am J Reprod Immunol. 2001;46:375–380

Bendikson K, Park J, Rosenwaks Z, Spandorfer S. Do cytokine levels in the supernatant from conditioned media of embryos grown in autologous endometrial coculture correlate with pregnancy outcomes after in vitro fertilization?. Fertil Steril. 2007;(Supp 1):88;O-152

Barmat LI, Liu HC, Spandorfer SD, Veek L, Damario M, Rosenwaks Z. Importance of the biopsy date in autologous endometrial cocultures for patients with multiple implantation failures. Fertil Steril. 2002;77:1209–1213Arnold JT, Kaufman DG, Seppala M, Lessey BA. Endometrial stromal cells regulate epithelial cell growth in vitro: a new co-culture model. Hum Reprod. 2001;16:836–845

Simon C, Mercader A, Garcia-Velasco J, Nikas G, Moreno C, Remohi J, et al. Coculture of human embryos with autologous human endometrial epithelial cells in patients with implantation failure. J Clin Endocrinol Metab. 1999;84:2638–2646

Mercader A, Garcia-Velasco JA, Escudero E, Remohi J, Pellicer A, Simon C. Clinical experience and perinatal outcome of blastocyst transfer after coculture of human embryos with human endometrial epithelial cells: a 5-year follow-up study. Fertil Steril. 2003;80:1162–1168

Simón C, Gimeno MJ, Mercader A, O’Connor JE, Remohí J, Polan ML, et al. Embryonic regulation of integrins beta 3, alpha 4, and alpha 1 in human endometrial epithelial cells in vitro. J Clin Endocrinol Metab. 1997;82:2607–2616

Simón C, Mercader A, Garcia-Velasco J, Nikas G, Moreno C, Remohí J, et al. Coculture of human embryos with autologous human endometrial epithelial cells in patients with implantation failure. J Clin Endocrinol Metab. 1999;84:2638–2646