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使用Versapoint重塑宫颈管以克服异常困难的胚胎移植并改善体外受精-胚胎移植结局：病例系列

Use of Versapoint to refashion the cervical canal to overcome unusually difficult embryo transfers and improve in-vitro fertilization-embryo transfer outcome: A case series.

作者信息

Mahajan Nalini, Gupta Ila

机构信息

Department of Infertility and IVF, Mother and Child Hospital, New Delhi, India.

出版信息

J Hum Reprod Sci. 2011 Jan;4(1):12-6. doi: 10.4103/0974-1208.82353.

DOI:10.4103/0974-1208.82353
PMID:21772733
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3136061/
Abstract

BACKGROUND

Smooth atraumatic embryo transfer is paramount for the success of in-vitro fertilization (IVF). In difficult cases, cervical canal manipulation may be required.

AIM

To see if surgical correction of the cervical canal or cervical canal refashioning could improve ease of embryo transfer.

SETTING

Private infertility and IVF hospital.

DESIGN

Prospective study.

PATIENTS

11 women with failed 1-3 IVF cycles with history of extremely difficult embryo transfers (ETs) despite undergoing cervical dilatation in the cycle prior to IVF.

INTERVENTIONS

Operative hysteroscopy using Versapoint for refashioning of the cervical canal.

MAIN OUTCOME MEASURES

Ease of ET in the subsequent IVF cycle. Secondary outcome measure was to assess reproductive outcome.

RESULTS

Easy and atraumatic ET in the IVF cycle after procedure in 100% patients. PR was 46.5%.

CONCLUSIONS

Use of Versapoint for refashioning the cervical canal can improve the quality of ET and PR.

摘要

背景

对于体外受精（IVF）的成功而言，顺利且无创的胚胎移植至关重要。在困难的情况下，可能需要对宫颈管进行操作。

目的

观察宫颈管的手术矫正或宫颈管重塑是否能提高胚胎移植的便利性。

地点

私立不孕不育与体外受精医院。

设计

前瞻性研究。

患者

11名女性，她们经历了1 - 3次体外受精周期失败，尽管在体外受精前的周期中进行了宫颈扩张，但胚胎移植（ET）极其困难。

干预措施

使用Versapoint进行手术宫腔镜检查以重塑宫颈管。

主要观察指标

后续体外受精周期中胚胎移植的便利性。次要观察指标是评估生殖结局。

结果

100%的患者在手术后的体外受精周期中实现了轻松且无创的胚胎移植。妊娠率为46.5%。

结论

使用Versapoint重塑宫颈管可提高胚胎移植质量和妊娠率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d463/3136061/67b947bf1d30/JHRS-4-12-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d463/3136061/cfdf980dc011/JHRS-4-12-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d463/3136061/67a7cd8e323e/JHRS-4-12-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d463/3136061/d5d7c096cadc/JHRS-4-12-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d463/3136061/36cd3f111d05/JHRS-4-12-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d463/3136061/67b947bf1d30/JHRS-4-12-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d463/3136061/cfdf980dc011/JHRS-4-12-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d463/3136061/67a7cd8e323e/JHRS-4-12-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d463/3136061/d5d7c096cadc/JHRS-4-12-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d463/3136061/36cd3f111d05/JHRS-4-12-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d463/3136061/67b947bf1d30/JHRS-4-12-g007.jpg

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本文引用的文献

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Improvement of pregnancy rate by modification of embryo transfer technique: a randomized clinical trial.改良胚胎移植技术提高妊娠率：一项随机临床试验。
Fertil Steril. 2010 Nov;94(6):2424-6. doi: 10.1016/j.fertnstert.2010.03.046. Epub 2010 May 7.
2
[Embryo transfer in case of stenosed and/or forbidding cervix].[宫颈狭窄和/或闭锁情况下的胚胎移植]
Gynecol Obstet Fertil. 2009 Nov-Dec;37(11-12):890-4. doi: 10.1016/j.gyobfe.2009.09.008.
3
Successful treatment of cervical stenosis with hysteroscopic canalization before embryo transfer in patients undergoing IVF: a case series.
体外受精周期中难易程度不同的胚胎移植结果比较。
Int J Fertil Steril. 2013 Jan;6(4):232-7. Epub 2013 Mar 3.
体外受精患者胚胎移植前宫腔镜下宫颈管疏通术成功治疗宫颈管狭窄：病例系列
J Minim Invasive Gynecol. 2005 Sep-Oct;12(5):436-8. doi: 10.1016/j.jmig.2005.06.003.
4
Cannulation of a resistant internal os with the malleable outer sheath of a coaxial soft embryo transfer catheter does not affect in vitro fertilization-embryo transfer outcome.使用同轴软胚胎移植导管的可塑形外鞘对坚韧的子宫内口进行插管不影响体外受精-胚胎移植结局。
Fertil Steril. 2004 Nov;82(5):1402-6. doi: 10.1016/j.fertnstert.2004.04.044.
5
The degree of difficulty of embryo transfer is an independent factor for predicting pregnancy.胚胎移植的难度程度是预测妊娠的一个独立因素。
Hum Reprod. 2002 Oct;17(10):2632-5. doi: 10.1093/humrep/17.10.2632.
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