The co-culture technique was first implemented in animal models in the mid-sixties in an attempt to improve the suboptimal conditions provided by culture media. Since then, autologous endometrial co-culture was introduced in human IVF, and different outcomes were reported regarding blastulation, fragmentation and implantation rates. Various growth factors and cytokines were proposed to be involved in the mechanism by which co-culture systems improved embryo development. However, randomized controlled trials are still warranted to provide evidence on the efficacy of endometrial co-cultures in the era of modern sequential- and monoculture media.
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