Infertility is a problem that affects approximately 1 in 6 couples at some stage in their lives. The cause may be found with the man, the woman, or both, and the intimate nature of the condition creates a great deal of personal distress and embarrassment.
Assisted Reproductive Technologies (or ART) are today widely used methods to overcome infertility. Generally known as IVF (In Vitro Fertilization), they include a variety of different methods such as IUI, IVF, GIFT, ZIFT, ICSI that may be indicated by the type of infertility encountered.
In this context, ANECOVA proposes a new approach in ART. The concept proposes to place the embryo in the maternal uterine cavity through all early development stages to benefit from the mother’s customized and adapted environment.
Culture Medium
In conventional IVF, the gametes (oocytes and sperm cells) are collected, fertilized, and cultured for 1 to 5 days in an artificial culture medium in the embryology lab. Once a number of the embryos have developed and achieved a state that allows them to be implanted in the uterine cavity, the embryologist makes a selection. The high- quality embryos are transferred to the uterus with the objective of implantation. Although it is widely used, the traditional IVF process has limitations: according to the European registries generated by the European Society of Human Reproduction and Embryology in 2003, the clinical pregnancy rate per embryo transfer was 29.6% 1
In vitro culture techniques and Embryo Quality
Although each stage of the IVF process presents challenges, in practice the rate-limiting step is the implantation. It depends on coordination and synchronization between the embryo and the uterus in which the quality of the embryos and the receptivity of the uterus play a determining role. Assessment protocols have been developed to qualify embryos on the basis of morphology but as yet there is no widely accepted technique to assess uterine receptivity.
In terms of embryo quality, the success of IVF was initially compromised by sub-optimal culture conditions resulting in impaired embryo development and decreased embryo viability. Over time, in vitro culture techniques have progressed considerably but the culture media remain artificial, often incorporating a number of additives that are absent from the uterine cavity. More importantly, the laboratory context misses all the biological interactions between the developing embryos and the maternal organism.
Physiological approach
The environment in which the very first stages of development take place is critical. Since animal data shows that exposure of embryos to different culture conditions can alter the expression and imprinting of a number of key genes2-5, it is paramount to try to replicate, in the lab, the physiologic composition of the natural environment. However, there have been very few studies investigating the impact of different culture media on chromosomal normality and the architecture of the mitotic spindle6.
The Anecova concept is to place the impregnated oocytes or zygotes in the maternal uterine cavity during the fertilization and/or early development stages, in order to benefit from its customized and adapted environment. (see also section: in vivo development by Anecova)
1 Andersen A.N et al. Human Reproduction Vol. 22, No. 6 pp. 1513-1525, 2007
2 Ho et al. Mol Reprod Dev 41, 232-238, 1995
3 Niemann et al. Theriogenology 53, 21-34, 2000
4 Khosla et al. Hum Reprod Update 7, 419-427, 2001
5 Doherty et al. Biol. Reprod. 62, 1526-1535, 2000
6 Winston & Hardy, Nature Cell Biology 8 (S1), S14-S18, 2002