Role of coculture in human in vitro fertilization: a meta-analysis

Objective: To evaluate the role of coculture in human IVF. Design: Meta-analysis. Setting/Patient(s)/Intervention(s): A literature search was performed using the Cochrane Menstrual Disorders and Subfertility Group Trials register, the Cochrane Central register of Controlled Trials on the Cochrane Library (2006), and MEDLINE (January 1966 to March 2006). Main Outcome Measure(s): Primary outcomes measured were implantation rates and pregnancy rates (clinical and ongoing). Secondary outcomes included evaluation of pre-embryo development based on average number of blastomeres per embryo. Result(s): A total of 17 prospective, randomized trials were identified. There was an overall statistically significant effect of coculture on the implantation rate, clinical pregnancy rate, and ongoing pregnancy rate. The cocultured embryos had greater numbers of blastomeres, although the data were heterogeneous. Conclusion(s): This is the first systematic, evidence-based review of randomized controlled trials to objectively determine the potential benefits of coculture in human IVF. The pooled data of human trials on coculture demonstrate a statistically significant improvement in blastomere number, implantation rates, and clinical and ongoing pregnancy rates.