Obstetrics and Gynaecology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy (Drs. Candiani, Vanni, Papaleo, Delprato, Tandoi, Parma, and Girardelli; Ms. Gervasio; and Ms. Corti).
Obstetrics and Gynaecology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy (Drs. Candiani, Vanni, Papaleo, Delprato, Tandoi, Parma, and Girardelli; Ms. Gervasio; and Ms. Corti).
J Minim Invasive Gynecol. 2020 Jan;27(1):74-79. doi: 10.1016/j.jmig.2019.02.023. Epub 2019 May 23.
To evaluate the treatment of patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome with a combination of oocyte retrieval and surgical vaginoplasty in a single laparoscopic procedure.
A case series.
The study was conducted at 2 tertiary referral facilities for MRKH syndrome in Milan, Italy, between July 2017 and September 2018.
Eleven patients presented with MRKH and required surgical vaginoplasty while expressing a desire for future fertility.
Two experienced surgeons and an expert in assisted reproductive technology performed concomitant vaginoplasty according to the modified technique of Davydov and laparoscopic oocyte retrieval for gamete cryopreservation.
Before the procedure, patients underwent extensive counseling and gave written consent. At the start of surgery, 10.4 ± 4.4 (mean ± standard deviation [SD]) oocytes were retrieved laparoscopically, and 8.8 ± 3.1 (SD) mean mature oocytes were cryopreserved. After oocyte retrieval, the steps of the modified Davydov technique were followed. The total operative time was 116 ± 16 minutes (mean ± SD), and no intraoperative/postoperative complications were observed.
This is the first report of combined oocyte retrieval and vaginoplasty for patients with MRKH syndrome. The approach was found to be feasible in patients with a desire for future fertility. It is our belief that physicians treating patients with MRKH should refer patients to centers with expertise in both vaginoplasty and assisted reproductive technology.
评估在单次腹腔镜手术中结合卵母细胞采集和手术阴道成形术治疗 Mayer-Rokitansky-Küster-Hauser（MRKH）综合征患者。
病例系列研究。
这项研究在意大利米兰的 2 家 MRKH 综合征的三级转诊中心进行，时间为 2017 年 7 月至 2018 年 9 月。
11 名患者患有 MRKH，需要手术阴道成形术，并表示希望未来有生育能力。
两位经验丰富的外科医生和一位辅助生殖技术专家按照 Davydov 改良技术进行同期阴道成形术，并进行腹腔镜卵母细胞采集以进行配子冷冻保存。
在手术前，患者接受了广泛的咨询并签署了书面同意书。在手术开始时，经腹腔镜采集了 10.4±4.4（平均值±标准差[SD]）个卵母细胞，并冷冻保存了 8.8±3.1（SD）个成熟卵母细胞。在卵母细胞采集后，按照改良 Davydov 技术的步骤进行操作。总手术时间为 116±16 分钟（平均值±SD），未观察到术中/术后并发症。
这是首例报告关于对 MRKH 综合征患者同时进行卵母细胞采集和阴道成形术的研究。该方法被认为在有未来生育需求的患者中是可行的。我们认为，治疗 MRKH 患者的医生应将患者转介到同时具有阴道成形术和辅助生殖技术专业知识的中心。
