摘要
目的探讨提高体外受精/卵胞质内单精子注射-胚胎移植(in vitro fertilization/intracytoplasmic sperm injection-embryo transfer, IVF/ICSI-ET)周期中经阴道获卵困难患者的取卵技巧, 以降低IVF/ICSI周期取消率。方法报道1例IVF/ICSI周期中经阴道取卵联合经腹部取卵的病例的临床资料。结果 1例因男方因素行ICSI助孕的不孕患者在促排卵过程中阴道超声监测反复未探及右侧卵巢, 使用促性腺激素第5日后出现右下腹腹痛。结合既往阑尾切除手术史, 考虑存在因盆腔粘连所致卵巢位置高, 并随后经腹部超声予以证实。取卵术式采用超声引导下经阴道联合经腹部穿刺取卵, 左右卵巢分别获得成熟卵子各2枚, ICSI授精后最终获胚4枚, 移植后生化妊娠。结论经腹部超声引导下取卵, 相对安全、有效, 可以获得和常规经阴道超声引导下取卵类似的临床结局;对于经阴道取卵困难的IVF/ICSI女性, 可以尝试选择经腹部超声取卵。在IVF/ICSI周期中, 需要提高病史询问、进周期前评估和促排卵监测、取卵及胚胎移植等各关键环节的质量。
Objective To improve the technique of oocyte retrieval in in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET)cycles and reduce the cancellation rate of IVF/ICSI cycle.Methods The clinical data of a case of IVF/ICSI cycle using transvaginal combined with abdominal oocyte retrieval was reported.Results The right ovary of one infertile patient who received ICSI due to male factors was not detected repeatedly by transvaginal ultrasound during ovulation induction.The right lower abdominal pain occurred day 5 after using gonadotropin.We considered that the position of the right ovary was high due to pelvic adhesion after previous appendectomy,and was further confirmed by abdominal ultrasound.Two mature oocytes were obtained from the left and right ovaries respectively.Four embryos were obtained after ICSI insemination,and biochemical pregnancy occurred after transplantation.Conclusion Transabdominal ultrasound-guided oocyte retrieval is relatively safe and effective,and can obtain similar clinical outcomes as conventional transvaginal ultrasound-guided oocyte retrieval.For IVF/ICSI women with difficulty in obtaining oocytes through vagina,transabdominal ultrasound-guided oocyte retrieval can be tried.During IVF/ICSI treatment cycles,it is necessary to improve the quality of medical history inquiry,pre-cycle evaluation,ovulation induction monitoring,oocyte retrieval and embryo transfer.
作者
张园
何国香
舒黎
吴畏
黄洁
冒韵东
马翔
Zhang Yuan;He Guoxiang;Shu Li;Wu Wei;Huang Jie;Mao Yundong;Ma Xiang(Department of Reproductive Medicine,the First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital,Nanjing 210029,China)
出处
《中华生殖与避孕杂志》
CSCD
北大核心
2022年第4期399-401,共3页
Chinese Journal of Reproduction and Contraception
基金
江苏省妇幼保健青年人才项目(FRC201793)
东南大学-南医大联合科研攻关项目(JX102GSP2017DN26)
江苏省科教强卫工程项目(YXZXB2016001)。
关键词
受精
体外
胚胎移植
取卵
经腹部
Fertilization in vitro
Embryo transfer
Oocyte retrieval
Transabdominal
