Carson S A, Smith A L, Scoggan J L, Buster J E
Department of Obstetrics and Gynecology, University of Tennessee, Memphis.
Prenat Diagn. 1991 Aug;11(8):513-22. doi: 10.1002/pd.1970110806.
Uterine lavage affords the potential for non-invasive human blastocyst recovery, with obvious potential for preimplantation genetic diagnosis. In an effort to duplicate in women the multiple blastocyst recovery per cycle that can be achieved in several other species, we initiated a programme in which fertile women underwent superovulation, followed by lavage and embryo collection. We superovulated 15 fertile women, aged 21-40, in 29 cycles using one of four regimens. Insemination was by either intercourse or artificial intracervical donor insemination with cryopreserved sperm from men of proven fertility. In 28 of 29 cycles, the uterus was lavaged daily for 1, 2, or 3 days between 5 and 10 days after human chorionic gonadotropin (hCG) administration or luteinizing hormone (LH) surge. Almost total fluid volume was recovered in every lavage. There were no retained pregnancies and no complications. Surprisingly, only two morulae, one blastocyst, and four unfertilized ova were recovered. Thus, alterations in ovulation induction, insemination timing, or lavage techniques must be contemplated in order to increase the blastocyst yield and thus fulfil the potential of uterine lavage for preimplantation diagnosis.
子宫灌洗为无创获取人类囊胚提供了可能，这对于植入前基因诊断具有明显的潜力。为了在女性中复制在其他一些物种中每个周期可实现的多个囊胚回收，我们启动了一项计划，让有生育能力的女性进行超排卵，随后进行灌洗和胚胎采集。我们使用四种方案之一，对15名年龄在21至40岁之间的有生育能力的女性进行了29个周期的超排卵。授精方式为性交或使用来自已证实有生育能力男性的冷冻精子进行人工宫颈内供体授精。在29个周期中的28个周期里，在注射人绒毛膜促性腺激素（hCG）或促黄体生成素（LH）激增后的5至10天之间，每天对子宫进行1、2或3天的灌洗。每次灌洗几乎回收了全部液体量。没有出现持续妊娠和并发症。令人惊讶的是，仅回收了两个桑葚胚、一个囊胚和四个未受精的卵子。因此，为了提高囊胚产量并从而实现子宫灌洗在植入前诊断中的潜力，必须考虑改变排卵诱导、授精时间或灌洗技术。
