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优化体外受精成功率:褪黑素辅助冻融胚胎移植治疗卵母细胞质量差和子宫内膜异位症的案例研究

Optimizing IVF Success: A Case Study of Melatonin-Assisted Frozen Embryo Transfer for Poor Oocyte Quality and Endometriosis.

作者信息

Dakre Sudanshu M, More Akash, Shrivastava Jarul, Choudhary Namrata, Khemani Shivani, Ulhe Shradha, Bondare Radha, Dutta Shilpa

机构信息

Department of Clinical Embryology, School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India.

Department of Clinical Embryology, Acharya Vinoba Bhave Rural Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India.

出版信息

J Pharm Bioallied Sci. 2024 Jul;16(Suppl 3):S2339-S2342. doi: 10.4103/jpbs.jpbs_183_24. Epub 2024 May 29.

Abstract

The case study investigates the journey of a couple facing infertility. It intensifies the challenges, including poor oocyte quality and endometriosis. In spite of two failed fertilization cycles, the decision for ovum pickup (OPU) was made, followed by intra-cytoplasmic sperm injection (ICSI), embryo treatment with melatonin, and frozen embryo transfer (FET) to optimize the chances of a successful pregnancy. The couple opted for this approach. OPU yielded four poor-quality oocytes, prompting ICSI and melatonin treatment to enhance embryo quality. The embryos were exposed to culture supplementation with melatonin for 72 hours before being transferred to conventional media. After 5 days or 120 hours, the embryos developed into 3BB quality blastocysts, indicative of developmental stage and morphology. The blastocysts were then cryopreserved, and after 2 months, FET was conducted, resulting in the transfer of two embryos, which subsequently led to a positive pregnancy indication, as indicated by a β-hCG level of 233 mUI/ml measured 14 days post transfer. This approach highlights the effectiveness of melatonin supplementation in improving embryo quality and ultimately facilitating successful pregnancy in complex scenarios like endometriosis-related infertility.

摘要

该案例研究调查了一对面临不孕问题的夫妇的历程。它加剧了各种挑战,包括卵母细胞质量差和子宫内膜异位症。尽管两个受精周期均失败,但还是决定进行取卵(OPU),随后进行卵胞浆内单精子注射(ICSI)、用褪黑素进行胚胎处理以及冷冻胚胎移植(FET),以优化成功怀孕的几率。这对夫妇选择了这种方法。OPU获得了四个质量较差的卵母细胞,促使进行ICSI和褪黑素处理以提高胚胎质量。在将胚胎转移到常规培养基之前,先让其在添加了褪黑素的培养基中培养72小时。5天后或120小时后,胚胎发育成3BB质量的囊胚,这表明了发育阶段和形态。然后将囊胚冷冻保存,两个月后进行FET,移植了两个胚胎,随后出现了阳性妊娠指征,移植后14天测得的β-hCG水平为233 mUI/ml。这种方法突出了补充褪黑素在改善胚胎质量以及最终在子宫内膜异位症相关不孕等复杂情况下促进成功怀孕方面的有效性。

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