Center for Reproductive Health and Gynecology, 99 N. La Cienega Blvd., Suite 109, Beverly Hills, CA, 90211, USA.
Punta Mita Fertility Center/Center for Reproductive Health and Gynecology, Punta Mita Hospital, Ramal Carretera Federal 200 KM 19 No. 1, C.P. 63734, Punta de Mita, Nayarit, Mexico.
Adv Ther. 2023 May;40(5):2534-2541. doi: 10.1007/s12325-023-02486-1. Epub 2023 Mar 29.
We wish to report the first live births from genetically screened human euploid blastocysts obtained by uterine lavage. The embryos transferred to infertile women were previously obtained using a novel fully automated uterine lavage catheter and fluid recovery device developed for this indication. The objective of this portion of the research was to confirm embryo implantation and live births with these unique in vivo conceived blastocysts obtained by uterine lavage.
In vivo conceived embryos recovered by uterine lavage 5 days after intrauterine insemination were available for embryo donation. In vivo embryos were the result of prior controlled ovarian stimulation cycles in oocyte donors and intrauterine insemination with donor sperm. An observational case series of nine embryo transfer procedures was performed at an outpatient fertility center. One to two embryos were transferred to eight infertile women since one woman had two separate embryo transfer procedures.
Nine embryo transfer procedures were performed with 14 blastocysts in eight women resulting in a blastocyst implantation rate of 36% (5/14) and live birth rate of 44% (4/9). Five infants have been born from the four delivered pregnancies with one set of twins.
This is the first report of live births from genetically screened human euploid blastocysts obtained by uterine lavage. The nonsurgical uterine lavage office procedure represents the only current approach to obtain in vivo conceived embryos and can provide a benchmark for comparison to standard in vitro cultured blastocysts. Live births of in vivo conceived blastocysts represent the validation that the nonsurgical uterine lavage procedure allows simplified access to naturally conceived embryos without performing the surgical procedure of an oocyte aspiration. Owing to its simplicity, uterine lavage may be useful in screening embryos for preimplantation genetic testing for aneuploidy in fertile and infertile couples.
ClinicalTrials.gov (Identifier NCT03426007).
我们报告首例通过子宫灌洗获得的经基因筛查的人类整倍体囊胚的活产。移植给不孕妇女的胚胎是先前使用一种新型全自动子宫灌洗导管和液体回收装置获得的，该装置是为此适应症开发的。本研究的目的是确认这些通过子宫灌洗获得的独特体内受精囊胚的胚胎着床和活产。
宫腔内人工授精后 5 天，通过子宫灌洗可获得体内受精胚胎，用于胚胎捐赠。体内胚胎是卵母细胞供体先前控制性卵巢刺激周期和供体精子宫腔内人工授精的结果。在一个门诊生育中心进行了九例胚胎移植程序的观察性病例系列研究。由于一名妇女进行了两次单独的胚胎移植程序，因此将一到两个胚胎移植到八名不孕妇女中。
对八名妇女的 14 个囊胚进行了 9 次胚胎移植，结果囊胚着床率为 36%（5/14），活产率为 44%（4/9）。四名孕妇中已有五名婴儿出生，其中一对是双胞胎。
这是首例通过子宫灌洗获得的经基因筛查的人类整倍体囊胚的活产报告。非手术性子宫灌洗办公室程序是目前唯一获得体内受精胚胎的方法，可以作为与标准体外培养囊胚进行比较的基准。体内受精囊胚的活产代表了非手术性子宫灌洗程序允许简化获得自然受孕胚胎的途径，而无需进行卵母细胞抽吸的手术程序。由于其简单性，子宫灌洗可能对筛查胚胎进行植入前遗传学检测整倍体在生育和不孕夫妇中有用。
ClinicalTrials.gov（标识符 NCT03426007）。
