Barbosa Marina Z, Zylbersztejn Daniel S, de Mattos Leandro A, Carvalho Luiz F
Baby Center, Institute for Reproductive Medicine, São Paulo, Brazil.
Institute of Clinical Research and Teaching Development, São Paulo, Brazil.
Minerva Ginecol. 2019 Jun;71(3):235-244. doi: 10.23736/S0026-4784.19.04319-3. Epub 2019 Feb 12.
3D printing has wide application in medicine while it provides customizability and precision for anatomical model development. Our aims were to perform a systematic review and to explore the use of 3D printing applications on human reproduction and reproductive surgery.
We have performed a systematic review in PubMed database to assess previous publications within 3D printing in human reproduction and gynecology. We have developed 3D models according to patients' magnetic resonance images (MRI). MRI were transformed into DICOM images that originated our 3D virtual models and PolyJet technology was applied for the printing process. We included two infertile patients in reproductive age with surgical indication for hysteroscopy septoplasty and myomectomy.
Of 1965 studies searched, we excluded 1934 publications based on their titles. Abstracts of 31 remained studies were read, and 24 studies were selected for full-text analysis. We included 11 studies for the systematic review, based on our eligibility criteria. We have designed four 3D models (uterus, ovaries, uterine cervix and uterus with fibroids) that provided enriched information to improve pre-surgical planning, medical training, fertility-sparing surgery, patient comprehension of surgical procedures and assisted reproduction applications.
3D models for human reproduction are feasible. They might improve assisted reproductive techniques, help in pre-surgical planning for reproductive surgeries, and provide accurate measures of ovarian reserve. Besides, we see future applications in endometrioma research and in the fabrication of devices, such as embryo transfer catheter and a 3D printed embryo.
3D打印在医学领域有着广泛应用，可为解剖模型的开发提供定制性和精确性。我们的目的是进行一项系统综述，并探索3D打印在人类生殖和生殖外科中的应用。
我们在PubMed数据库中进行了系统综述，以评估以往关于3D打印在人类生殖和妇科领域的出版物。我们根据患者的磁共振成像（MRI）开发了3D模型。MRI被转换为DICOM图像，由此生成我们的3D虚拟模型，并应用PolyJet技术进行打印过程。我们纳入了两名有宫腔镜纵隔切除术和子宫肌瘤切除术手术指征的育龄不孕患者。
在检索到的1965项研究中，我们根据标题排除了1934篇出版物。阅读了其余31项研究的摘要，并选择了24项研究进行全文分析。根据我们的纳入标准，我们纳入了11项研究进行系统综述。我们设计了四个3D模型（子宫、卵巢、子宫颈和带肌瘤的子宫），这些模型提供了丰富的信息，有助于改善术前规划、医学培训、保留生育功能的手术、患者对手术过程的理解以及辅助生殖应用。
人类生殖的3D模型是可行的。它们可能会改善辅助生殖技术，有助于生殖手术的术前规划，并提供准确的卵巢储备测量。此外，我们预见其在子宫内膜异位症研究以及诸如胚胎移植导管和3D打印胚胎等器械制造方面的未来应用。
