Der Gynäkologe

, Volume 37, Issue 8, pp 696–700 | Cite as

Blastozystenkultur

Pro und Contra
Zum Thema
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Zusammenfassung

Blastozystenkultur und -transfer unter Einsatz sequenzieller, dem wechselnden Substratbedarf der Präimplantationsembryonen angepasster Kulturmedien hat sich im Ausland zu einer etablierten Therapie im Rahmen der In-vitro-Fertilisationsbehandlung entwickelt. Die Raten der Embryonen, die nach 5 Tagen das Blastozystenstadium erreichen, sind reproduzierbar hoch, der Anteil an Zyklen ohne konsekutiven Transfer ist gering. Während in den meisten retrospektiven Studien eine Erhöhung von Implantations- und Schwangerschaftsraten beschrieben wird, lässt sich dies in prospektiven Studien nur für die Implantationsrate bestätigen. Die besseren Implantationsraten scheinen hauptsächlich durch die Möglichkeit der Selektion der Präimplantationsembryonen während der 5-tägigen In-vitro-Kultur bedingt zu sein, weniger durch eine evtl. verbesserte Synchronisation von Embryo und Endometrium. Daher erscheint der routinemäßige Einsatz in Deutschland unter den durch das Embryonenschutzgesetz bestehenden Limitierungen nicht sinnvoll.

Schlüsselwörter

Blastozystenkultur Embryonalentwicklung Implantation Blastozystentransfer Embryonenschutzgesetz 

Blastocyst culture

Pros and cons

Abstract

Blastocyst culture and transfer using sequential culture media that have been specifically designed to mimic the tubal and uterine environment are established therapeutic options in human in vitro fertilization. Blastocyst development rates are reproducibly high and cycle cancellation rates are negligibly low in most countries. While most retrospective studies described higher implantation rates and pregnancy rates, only implantation rates appear to be higher in prospective trials. Higher implantation rates are most likely caused by a better possibility to select good-quality embryos in terms of morphology and growth rate for transfer, not by a better synchronization between embryo and endometrium. Since the selection of embryos is currently prohibited by the German Embryo Protection Law, blastocyst culture and transfer cannot be routinely recommended in Germany.

Keywords

Blastocyst culture Preimplantation embryo development Implantation Blastocyst transfer Embryo Protection Law 

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Copyright information

© Springer Medizin Verlag 2004

Authors and Affiliations

  • J. S. Krüssel
    • 1
    • 2
  • J. Hirchenhain
    • 1
  • H. G. Bender
    • 1
  1. 1.Universitätsfrauenklinik Düsseldorf
  2. 2.Interdisziplinäres Zentrum für ReproduktionsmedizinUniversitätsfrauenklinik DüsseldorfDüsseldorf

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