Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center and Chang Gung University, Taoyuan, Taiwan.
School of Medicine, Chang Gung University, Taoyuan, Taiwan.
Taiwan J Obstet Gynecol. 2024 Sep;63(5):737-740. doi: 10.1016/j.tjog.2023.06.006.
Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare congenital disorder that results in vaginal agenesis. Lee's neovaginoplasty is a novel surgery for reconstructing the vagina. Transneovaginal oocyte retrieval completely changes the scope of fertility for patients with MRKH syndrome who have undergone neovaginal reconstruction.
A 22-year-old female with type 1 MRKH syndrome underwent Lee's neovaginoplasty successfully. Four years later, she sought embryo cryopreservation consultation and underwent controlled ovarian hyperstimulation. Upon examination, her anti-Müllerian hormone level was 1.97 ng/ml and she had only eight antral follicles. The neovaginal length was 8 cm with elasticity and extensibility. Transneovaginal oocyte retrieval was performed under ultrasound guidance, and seven oocytes were retrieved. The follicle-to-oocyte index was 87.5%.
Lee's neovaginoplasty is a promising surgery for reconstructing the vagina in MRKH syndrome, and this case shows that transneovaginal oocyte retrieval can be successfully performed after vaginal reconstruction. This technique provides a minimally invasive option for retrieving oocytes in patients of MRKH syndrome.
Mayer-Rokitansky-Küster-Hauser(MRKH)综合征是一种罕见的先天性疾病,导致阴道发育不全。Lee 的阴道成形术是一种重建阴道的新手术。经阴道取卵术彻底改变了接受阴道重建的 MRKH 综合征患者的生育范围。
一名 22 岁的 1 型 MRKH 综合征女性成功接受了 Lee 的阴道成形术。四年后,她寻求胚胎冷冻保存咨询并接受了控制性卵巢过度刺激。检查时,她的抗苗勒氏管激素水平为 1.97ng/ml,只有 8 个窦卵泡。阴道新长度为 8cm,有弹性和可扩展性。在超声引导下进行经阴道取卵,共取出 7 个卵子。卵泡-卵母细胞指数为 87.5%。
Lee 的阴道成形术是一种有前途的重建 MRKH 综合征阴道的手术,本病例表明阴道重建后可成功进行经阴道取卵。这项技术为 MRKH 综合征患者取卵提供了一种微创选择。