[Intravaginal culture and embryo transfer. A new method for the fertilization of human oocytes]

This technique was developed at the University Clinic of Port-Royal. It corresponds to the intravaginal culture of embryos and their transfer into the uterus. After ovocyte stimulation, most often by Clomid HMG, the follicles are aspirated under laparoscopic or sonographic control 34 to 36 hours after HCG. After being collected, the ovocytes are placed, whatever their stage of maturity, in one or several 3 ml tubes completely filled with culture medium (B2 of pure Menezo). Up to 4 ovocytes per tube are thus fertilized with 10 to 20,000 mobile spermatozoids/ml, prepared in the usual dilution, centrifugation and migration. Then the tube(s) are placed in the posterior vaginal cul-de-sac, kept in place with a diaphragm where they will remain during the 44 to 48 hours of culture time. Following that time, the contents of the tube are examined in order to evaluate the occurrence and the stage of embryonic division. A first series of 100 aspirations has enabled to obtain 15 pregnancies, still evolving, including two births of healthy children. A randomized series is currently in progress to determine a possible difference in the rates of pregnancy between CIVETE and the classic technique. Beside its new psychological contribution, this technique has demonstrated that it was possible to culture human embryos in the absence of CO2; its extreme simplicity should lead to a broader expansion of this technique.