Chief Genomics Officer, Kindbody; Medical and IVF Practice Director, Kindbody St Louis, MO, USA.
Curr Opin Obstet Gynecol. 2022 Aug 1;34(4):179-183. doi: 10.1097/GCO.0000000000000803.
To discuss existing literature and current use of intravaginal culture (IVC) as an option for patients seeking fertility therapies.
IVC is the combination of oocytes and sperm with culture media in a sealed device that is placed vaginally and left in place while fertilization and early embryo development occurs. Studies show that IVC is safe, well-tolerated, and has similar outcomes in patients as compared to standard in vitro fertilization techniques (conventional insemination and/or intracytoplasmic sperm injection). The new device, INVOcell, while recommended by the FDA for minimal stimulation and up to 72 h of culture and seven oocytes, has been used successfully with more oocytes and for 5 days (until blastocyst stage for transfer) in many centers. Live birth rates and neonatal outcomes are reassuring.
Infertility is a common disease and the vast majority of patients globally will not seek care. IVC may improve access to care, lower costs, provide an alternative for patients who have ethical or religious concerns, and be an increasingly utilized option for those seeking ART therapies. It may also ease workflow burdens in labs where space, equipment, or highly trained lab staff are scarce. More data is warranted to track cumulative outcomes and optimize the ideal patient candidate, but it is a viable alternative in the armamentarium of fertility therapies.
讨论将阴道内培养（IVC）作为寻求生育治疗的患者的一种选择的现有文献和当前用途。
IVC 是将卵母细胞和精子与培养液在一个密封装置中结合，将该装置放置在阴道内并在受精和早期胚胎发育过程中留在原处。研究表明，IVC 是安全的、耐受良好的，并且与标准体外受精技术（常规授精和/或胞浆内精子注射）相比，在患者中的结果相似。新设备 INVOcell 已被 FDA 推荐用于最小刺激和长达 72 小时的培养和 7 个卵母细胞，但许多中心已成功使用更多的卵母细胞和长达 5 天（直到囊胚阶段进行转移）。活产率和新生儿结局令人放心。
不孕是一种常见疾病，全球绝大多数患者不会寻求治疗。IVC 可能会增加获得治疗的机会，降低成本，为有伦理或宗教顾虑的患者提供替代方案，并且可能成为寻求 ART 治疗的患者越来越多的选择。它还可以减轻空间、设备或高度训练有素的实验室人员稀缺的实验室的工作流程负担。需要更多的数据来跟踪累积结果并优化理想的患者候选者，但它是生育治疗武器库中的一种可行替代方案。
