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李式阴道成形术后经阴道取卵术治疗苗勒氏管发育不全综合征的病例研究

A case study of transneovaginal oocyte retrieval after novel Lee's neovaginoplasty in Mayer-Rokitansky-Küster-Hauser syndrome.

机构信息

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.

出版信息

Taiwan J Obstet Gynecol. 2024 Sep;63(5):737-740. doi: 10.1016/j.tjog.2023.06.006.

Abstract

OBJECTIVE

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.

CASE REPORT

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%.

CONCLUSION

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.

摘要

目的

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。

病例报告

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%。

结论

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。

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