Department of Reproduction Center, the Third Affiliated Hospital, Zhengzhou University, Zhengzhou, China.
Curr Med Res Opin. 2023 May;39(5):797-801. doi: 10.1080/03007995.2023.2192609. Epub 2023 Apr 8.
To explore a non-routine method of oocyte retrieval in patients with difficulty in obtaining oocytes the vagina during a cycle of fertilization (IVF)/intracytoplasmic sperm injection (ICSI)-embryo transfer (ET).
We report the clinical data of one case of combined transabdominal and transvaginal egg retrieval with a vaginal ultrasound probe in a patient with adenomyosis undergoing IVF/ICSI for fertilization.
A patient with infertility due to adenomyosis desired fertility. During vaginal ultrasound monitoring before ovulation induction, it was found that most of the pelvic cavity was occupied by the uterus. The uterus was (116 mm + 30 mm) × 110 mm × 108 mm and the right ovary was extremely high. The right ovary was not clear on transvaginal ultrasound but it could be displayed by abdominal ultrasound. The Cancer antigen 125(CA125) before starting the fertility cycle was 532.5 U/mL. On the 7th day of the cycle, she complained of mild pain and discomfort in the abdomen, and the size of the uterus was found to be (128 mm + 30 mm) × 125 mm × 110 mm, and her Cancer antigen 125(CA125) was 1109 U/mL. After a total of 13 days of stimulation, the eggs were retrieved. The ovum retrieval procedure used a vaginal ultrasound probe to guide retrieval of the eggs puncture through the abdomen. A total of 12 and 9 mature eggs were obtained from the left and right ovaries, respectively, and 1 embryo and 9 blastocysts were frozen after insemination. The patient was undergoing treatment for adenomyosis, and no embryos had been transferred.
Transabdominal ovum retrieval guided by a vaginal ultrasound probe is a feasible, effective, and safe method for obtaining oocytes for patients who cannot retrieve eggs vaginally. In the clinical work of IVF/ICSI fertility, it is necessary to obtain a thorough medical history and assess the patient's condition before the cycle and conduct multidisciplinary consultation on difficult cases to improve the likelihood of pregnancy.
探索一种在受精（IVF）/卵胞浆内单精子注射（ICSI）-胚胎移植（ET）周期中阴道取卵困难的患者获得卵子的非常规方法。
我们报告了一例腺肌症患者行 IVF/ICSI 受精时联合经腹经阴道超声探头取卵的临床资料。
一位因腺肌症导致不孕的患者希望生育。在排卵诱导前进行阴道超声监测时，发现大部分盆腔被子宫占据。子宫大小为（116mm+30mm）×110mm×108mm，右侧卵巢极高。经阴道超声无法显示右侧卵巢，但可以通过腹部超声显示。开始生育周期前的癌抗原 125（CA125）为 532.5U/ml。周期第 7 天，患者诉腹痛不适，子宫大小为（128mm+30mm）×125mm×110mm，CA125 为 1109U/ml。共刺激 13 天后取卵。卵母细胞采集采用阴道超声探头引导经腹部穿刺。分别从左、右侧卵巢获得 12 个和 9 个成熟卵子，受精后冷冻 1 个胚胎和 9 个囊胚。患者正在接受腺肌症治疗，未进行胚胎移植。
经阴道超声探头引导的经腹取卵是一种可行、有效、安全的方法，适用于无法经阴道取卵的患者获得卵子。在 IVF/ICSI 生育的临床工作中，有必要在周期前详细了解病史，评估患者病情，并对疑难病例进行多学科会诊，以提高妊娠率。
