Name: op-ivm: combining in vitro maturation after oocyte retrieval with gynecological surgery
Uploaded: 2021-05-09T14:00:00
Description: Watch this Scientific Journal Video about OP-IVM: Combining In vitro Maturation after Oocyte Retrieval with Gynecological Surgery at JoVE.com

Dette arbejde blev støttet af tilskud fra China National Key R &D Program (nr. 2017YFC1002000, 2018YFC1004001, 2019YFA0801400), National Science Foundation of China (nr. 81571386, 81730038), CAMS Innovation Fund for Medical Sciences (2019-I2M-5-001) og specialforskningsprojektet for kinesisk kapitalsundhedsudvikling (2018-2-4095).

BEMÆRK: Undersøgelser relateret til OP-IVM-metoden er blevet godkendt af det institutionelle review board (IRB) på Peking University Third Hospital og den etiske komité for Peking University (2014S2004). Et resumé af OP-IVM er vist i figur 1. Den trinvise procedure vil blive indført i det følgende afsnit.
1. Indførelse af OP-IVM til relevante patienter
<ol><li>Identificere potentielle patienter, der kan drage fordel af OP-IVM, som dem, der er beskrevet i...

<ol>
	<li>Ho, V. N. A., Braam, S. C., Pham, T. D., Mol, B. W., Vuong, L. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effectiveness+and+safety+of+in+vitro+maturation+of+oocytes+versus+in+vitro+fertilization+in+women+with+a+high+antral+follicle+count.">The effectiveness and safety of in vitro maturation of oocytes versus in vitro fertilization in women with a high antral follicle count.</a> Human Reproduction. 34 (6), 1055-1064 (2019).</li><li>Yang, Z. Y., Chian, R. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Development+of+in+vitro+maturation+techniques+for+clinical+applications.">Development of in vitro maturation techniques for clinical applications.</a> Fertility and Sterility. 108 (4), 577-584 (2017).</li><li>Hatirnaz, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Oocyte+in+vitro+maturation:+A+sytematic+review.">Oocyte in vitro maturation: A sytematic review.</a> Turkish Journal of Obstetrics and Gynecology. 15 (2), 112-125 (2018).</li><li>Gremeau, A. S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vitro+maturation+or+in+vitro+fertilization+for+women+with+polycystic+ovaries?+A+case-control+study+of+194+treatment+cycles.">In vitro maturation or in vitro fertilization for women with polycystic ovaries? A case-control study of 194 treatment cycles.</a> Fertility and Sterility. 98 (2), 355-360 (2012).</li><li>Ho, V. N. A., Braam, S. C., Pham, T. D., Mol, B. W., Vuong, L. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effectiveness+and+safety+of+in+vitro+maturation+of+oocytes+versus+in+vitro+fertilization+in+women+with+a+high+antral+follicle+count.">The effectiveness and safety of in vitro maturation of oocytes versus in vitro fertilization in women with a high antral follicle count.</a> Human Reproduction. 34 (6), 1055-1064 (2019).</li><li>Sahin, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Which+should+be+the+preferred+technique+during+laparoscopic+ovarian+cystectomy.">Which should be the preferred technique during laparoscopic ovarian cystectomy.</a> Reproductive Sciences. 24 (3), 393-399 (2017).</li><li>Xiao, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Impact+of+hemostatic+methods+on+ovarian+reserve+and+fertility+in+laparoscopic+ovarian+cystectomy.">Impact of hemostatic methods on ovarian reserve and fertility in laparoscopic ovarian cystectomy.</a> Experimental and Therapeutic. 17 (4), 2689-2693 (2019).</li><li>Song, X. -. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Enhancing+the+scope+of+in+vitro+maturation+for+fertility+preservation:+transvaginal+retrieval+of+immature+oocytes+during+endoscopic+gynaecological+procedures.">Enhancing the scope of in vitro maturation for fertility preservation: transvaginal retrieval of immature oocytes during endoscopic gynaecological procedures.</a> Human Reproduction. 35 (4), 837-846 (2020).</li><li>Magnusson, &. #. 1. 9. 7. ;., K&#228;llen, K., Thurin-Kjellberg, A., Bergh, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+number+of+oocytes+retrieved+during+IVF:+a+balance+between+efficacy+and+safety.">The number of oocytes retrieved during IVF: a balance between efficacy and safety.</a> Human Reproduction. 33 (1), 58-64 (2018).</li><li>Larose, H., et al., Wellik, D. M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gametogenesis:+A+journey+from+inception+to+conception.">Gametogenesis: A journey from inception to conception.</a> Current Topics in Developmental Biology. 132, 257-310 (2019).</li><li>Broer, S. L., Broekmans, F. J. M., Laven, J. S. E., Fauser, B. C. J. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anti-M&#252;llerian+hormone:+ovarian+reserve+testing+and+its+potential+clinical+implications.">Anti-M&#252;llerian hormone: ovarian reserve testing and its potential clinical implications.</a> Human Reproduction Update. 20 (5), 688-701 (2014).</li><li>Arce, J. C., La Marca, A., Mirner Klein, B., Nyboe Andersen, A., Fleming, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Antim&#252;llerian+hormone+in+gonadotropin+releasing-hormone+antagonist+cycles:+prediction+of+ovarian+response+and+cumulative+treatment+outcome+in+good-prognosis+patients.">Antim&#252;llerian hormone in gonadotropin releasing-hormone antagonist cycles: prediction of ovarian response and cumulative treatment outcome in good-prognosis patients.</a> Fertility and Sterility. 99 (6), 1644-1653 (2013).</li><li>Katayama, K. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Ultrasound-guided+transvaginal+needle+aspiration+of+follicles+for+in+vitro+fertilization.">Ultrasound-guided transvaginal needle aspiration of follicles for in vitro fertilization.</a> Obstetrics and Gynecology. 72 (2), 271-274 (1988).</li><li>Dellenbach, P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transvaginal+sonographically+controlled+follicle+puncture+for+oocyte+retrieval.">Transvaginal sonographically controlled follicle puncture for oocyte retrieval.</a> Fertility and Sterility. 44 (5), 656-662 (1985).</li><li>Hirata, T., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Concomitant+ovarian+drilling+and+oocyte+retrieval+by+laparoendoscopic+single-site+surgery+led+to+live+birth+using+in+vitro+maturation+of+oocyte+and+transfer+of+frozen-thawed+blastocyst+in+woman+with+polycystic+ovary+syndrome.">Concomitant ovarian drilling and oocyte retrieval by laparoendoscopic single-site surgery led to live birth using in vitro maturation of oocyte and transfer of frozen-thawed blastocyst in woman with polycystic ovary syndrome.</a> Journal of Obstetrics and Gynaecology Research. 40 (5), 1431-1435 (2014).</li><li>Deutinger, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Follicular+aspiration+for+in+vitro+fertilization:+sonographically+guided+transvaginal+versus+laparoscopic+approach.">Follicular aspiration for in vitro fertilization: sonographically guided transvaginal versus laparoscopic approach.</a> European Journal of Obstetrics, Gynecology, and Reproductive Biology. 26 (2), 127-133 (1987).</li><li>Tanbo, T., Henriksen, T., Magnus, O., Abyholm, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Oocyte+retrieval+in+an+IVF+program.+A+comparison+of+laparoscopic+and+transvaginal+ultrasound-guided+follicular+puncture.">Oocyte retrieval in an IVF program. A comparison of laparoscopic and transvaginal ultrasound-guided follicular puncture.</a> Acta Obstetricia et Gynecologica Scandinavica. 67 (3), 243-246 (1988).</li><li>Nagy, Z. P., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pregnancy+and+birth+after+intracytoplasmic+sperm+injection+of+in+vitro+matured+germinal-vesicle+stage+oocytes:+case+report.">Pregnancy and birth after intracytoplasmic sperm injection of in vitro matured germinal-vesicle stage oocytes: case report.</a> Fertility and Sterility. 65 (5), 1047-1050 (1996).</li><li>S&#246;derstr&#246;m-Anttila, V., M&#228;kinen, S., Tuuri, T., Suikkari, A. -. M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Favourable+pregnancy+results+with+insemination+of+in+vitro+matured+oocytes+from+unstimulated+patients.">Favourable pregnancy results with insemination of in vitro matured oocytes from unstimulated patients.</a> Human Reproduction. 20 (6), 1534-1540 (2005).</li><li>Hwang, J. L., Lin, Y. H., Tsai, Y. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=In+vitro+maturation+and+fertilization+of+immature+oocytes:+a+comparative+study+of+fertilization+techniques.">In vitro maturation and fertilization of immature oocytes: a comparative study of fertilization techniques.</a> Journal of Assisted Reproduction and Genetics. 17 (1), 39-43 (2000).</li><li>Walls, M., Junk, S., Ryan, J. P., Hart, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=IVF+versus+ICSI+for+the+fertilization+of+in-vitro+matured+human+oocytes.">IVF versus ICSI for the fertilization of in-vitro matured human oocytes.</a> Reproductive Biomedicine Online. 25 (6), 603-607 (2012).</li><li>Park, J. H., Jee, B. C., Kim, S. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+normal+and+abnormal+fertilization+of+in+vitro-matured+human+oocyte+according+to+insemination+method.">Comparison of normal and abnormal fertilization of in vitro-matured human oocyte according to insemination method.</a> Journal of Obstetrics and Gynaecology Research. 42 (4), 417-421 (2016).</li><li>Ho, V. N. A., Pham, T. D., Le, A. H., Ho, T. M., Vuong, L. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Live+birth+rate+after+human+chorionic+gonadotropin+priming+in+vitro+maturation+in+women+with+polycystic+ovary+syndrome.">Live birth rate after human chorionic gonadotropin priming in vitro maturation in women with polycystic ovary syndrome.</a> Journal of Ovarian Research. 11 (1), 70 (2018).</li><li>Zheng, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+hCG+priming+on+embryonic+development+of+immature+oocytes+collected+from+unstimulated+women+with+polycystic+ovarian+syndrome.">Effect of hCG priming on embryonic development of immature oocytes collected from unstimulated women with polycystic ovarian syndrome.</a> Reproductive Biology and Endocrinology. 10, 40 (2012).</li><li>Tannus, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Predictive+factors+for+live+birth+after+in+vitro+maturation+of+oocytes+in+women+with+polycystic+ovary+syndrome.">Predictive factors for live birth after in vitro maturation of oocytes in women with polycystic ovary syndrome.</a> Archives of Gynecology and Obstetrics. 297 (1), 199-204 (2018).</li><li>Cohen, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Decreased+pregnancy+and+live+birth+rates+after+vitrification+of+in+vitro+matured+oocytes.">Decreased pregnancy and live birth rates after vitrification of in vitro matured oocytes.</a> Journal of Assisted Reproduction and Genetics. 35 (9), 1683-1689 (2018).</li><li>Yazdanpanah, F., Khalili, M. A., Eftekhar, M., Karimi, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+effect+of+vitrification+on+maturation+and+viability+capacities+of+immature+human+oocytes.">The effect of vitrification on maturation and viability capacities of immature human oocytes.</a> Archives of Gynecology and Obstetrics. 288 (2), 439-444 (2013).</li></ol>

OP-IVM-metoden, der er beskrevet i denne artikel, omfatter konventionelle IVM-applikationer og kombinerer IVM efter oocyt-hentning med rutinemæssig gynækologisk kirurgi. Oocytter, der ville have været tabt i gynækologisk kirurgi kan nu bruges til IVF-ET eller FP uden yderligere kirurgiske risici. OP-IVM blev først brugt til at hente oocytter før ovarieboring hos PCOS-patienter. Dens anvendelse hurtigt udvidet til ufrugtbare patienter, der har brug for godartet gynækologisk kirurgi og kræft eller hæmatologiske sy...

An erratum was issued for:&#160;<a href="https://www.jove.com/t/61647">OP-IVM: Combining In vitro Maturation after Oocyte Retrieval with Gynecological Surgery</a>. The Protocol and Representative Results sections were&#160;updated.
Step 3.2 of the Protocol was updated from:
Add 0.5 mL of IVM&#160;medium supplemented with 0.075 IU/mL of follicle-stimulating hormone (FSH) and 0.075 IU/mL of luteinizing hormone (LH) to each well of a 4-well plate. Cover the medium with oil.
to:
Add 0.5 mL of IVM&#160;medium supplemented with 0.75 IU/mL of follicle-stimulating hormone (FSH) and 0.75 IU/mL of luteinizing hormone (LH) to each well of a 4-well plate. Cover the medium with oil.
The legend for Figure 2 was updated from:
Figure 2:&#160;Morphological characteristics of representative images of oocytes. (A) COCs, (B) MII, (C) MI, (D) GV stage. Abbreviations: COCs = cumulus-oocyte complexes; GV = germinal vesicle; MI = metaphase I; MII = metaphase II.
to:
Figure 2:&#160;Morphological characteristics of representative images of oocytes. (A) COCs, (B) GV, (C) MI, (D) MII&#160;stage. Abbreviations: COCs = cumulus-oocyte complexes; GV = germinal vesicle; MI = metaphase I; MII = metaphase II.

An erratum was issued for:&#160;<a href="https://www.jove.com/t/61647">OP-IVM: Combining In vitro Maturation after Oocyte Retrieval with Gynecological Surgery</a>. The Protocol and Representative Results sections were&#160;updated.

Erratum: OP-IVM: Combining In vitro Maturation after Oocyte Retrieval with Gynecological Surgery

IVM er en ART, hvor menneskelige umodne oocytter dyrkes in vitro til modning til IVF-ET eller FP. I IVM anvendes ægløsningsinduktionsmedicin ikke, hvilket reducerer smerter, økonomiske byrder og komplikationer som ovarie hyperstimulationssyndrom (OHSS)1,2. Derudover er IVM særligt velegnet til FP af kræftpatienter og infertilitetsbehandling af hormonfølsomme patienter, som måske ikke er i stand til eller ikke har tid til at modtage ægløsningsbehandling3. Derfor, selv om antallet af oocytter hentet, klinisk graviditet sats (CPR), og levende fødselsrate (LBR) er lavere end i IVF4,5, IVM har sine egne unikke fordele.
Ufrugtbare patienter med endometrielæsioner, hydrosalpinx, eller ovariecyster normalt har gynækologisk kirurgi før ART behandling, og deres oocytter er normalt umodne. OP-IVM bruger guidet transvaginale ultralyd til at hente de umodne oocytter og dyrke dem in vitro indtil modning for IVF-ET eller FP. OP-IVM kombinerer IVM efter oocyt hentning og gynækologisk kirurgi, hvilket reducerer komplikationer, der er almindelige i kontrollerede æggestokke hyperstimulation cykler og spare tid og penge. For frugtbare patienter, OP-IVM kunne tjene som en "fertilitetsforsikring", mens de gennemgår rutinemæssig gynækologisk kirurgi.
Desuden, skader forårsaget af gynækologiske operationer, såsom elektrokauteri6,7 og ovarie tumor resektion, kunne reduceres gennem oocyt hentning før gynækologisk kirurgi. Sammenlignet med rutinemæssig gynækologisk kirurgi kunne OP-IVM derfor reducere antallet af operationer under infertilitetsbehandling og forhindre tab af funktionelle oocytter under ovariekirurgi.
En tidligere undersøgelse har vist, at den ekstra procedure for oocyt hentning hverken ville øge kirurgiske komplikationer og negative graviditetsresultater eller forlænge hospitalsopholdet8. Nogle patienter har født levende gennem OP-IVM8, hvilket indikerer gennemførligheden af denne metode. Dette dokument beskriver karakteristika for patienter, der kan drage fordel af OP-IVM samt procedurer og kritiske punkter i OP-IVM og diskuterer evalueringen af menneskelig oocyt modenhed.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>19 G single-lumen aspiration needles</td>
			<td>Cook, Australia</td>
			<td>K-OPS-7035-REH-ET</td>
			<td></td>
		</tr>
		<tr>
			<td>4-well plate</td>
			<td>Corning</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>70 &#956;m nylon cell strainer</td>
			<td>Falcon, USA</td>
			<td>352350</td>
			<td></td>
		</tr>
		<tr>
			<td>CO2 Incubator</td>
			<td>Thermo</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Culture oil</td>
			<td>Vitrolife, Sweden</td>
			<td>10029,OVOIL&#160;</td>
			<td>Step 3.2.</td>
		</tr>
		<tr>
			<td>FSH &#38; LH</td>
			<td>Ferring Reproductive Health, Germany</td>
			<td>MENOPUR&#174;</td>
			<td></td>
		</tr>
		<tr>
			<td>Glass Pasteur pipette</td>
			<td>Hilgenberg GmbH, Germany</td>
			<td>3154102-26</td>
			<td></td>
		</tr>
		<tr>
			<td>G-MOPS medium</td>
			<td></td>
			<td></td>
			<td>pH-stable handling medium for washing the needle before puncturing</td>
		</tr>
		<tr>
			<td>IVM medium</td>
			<td>Origio, Denmark</td>
			<td>ART-1600-B</td>
			<td></td>
		</tr>
		<tr>
			<td>Laminar Flow Clean Benches</td>
			<td>ESCO</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Petri dish</td>
			<td>Thermo Fisher Scientific, Denmark</td>
			<td>263991</td>
			<td></td>
		</tr>
		<tr>
			<td>pH stable handing media designed to support the handling and manipulation of oocytes and embryos outside the incubator</td>
			<td>Vitrolife, Sweden</td>
			<td>10130, G-MOPS PLUS</td>
			<td>Step 7.1.</td>
		</tr>
		<tr>
			<td>Rinse solution</td>
			<td>Cook, Australia</td>
			<td>K-SIFB-100</td>
			<td></td>
		</tr>
		<tr>
			<td>Stereoscope</td>
			<td>Nikon</td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

op-ivm: combining in vitro maturation after oocyte retrieval with gynecological surgery

Brugen af in vitromodning (IVM) før gynækologisk operation (OP-IVM) er en udvidelse af konventionel IVM, der kombinerer IVM efter oocyt hentning med rutinemæssig gynækologisk kirurgi. OP-IVM er velegnet til patienter, der gennemgår godartet gynækologisk kirurgi, og som har behov for fertilitetsbevarelse (FP) eller infertilitetsbehandlinger såsom in vitro-befrugtning og embryooverførsel (IVF-ET). På operationsstuen bedøves patienter, der gennemgår godartet gynækologisk kirurgi, først bedøvet og modtager ultralydstyret umoden follikel aspiration (IMFA) behandling. Efterhånden som den efterfølgende gynækologiske operation udføres, undersøges cumulus-oocytkomplekserne (COC'er), og de umodne COC'er overføres til IVM-mediet og dyrkes i 28-32 timer i IVF-laboratoriet. Efter vurdering vil modne oocytter i MII-stadiet blive udvalgt og kryopreserveret i flydende nitrogen til FP eller befrugtet ved intracytoplasmisk sædindsprøjtning (ICSI) til IVF-ET. Ved at kombinere IVM med gynækologisk kirurgi, umodne oocytter, der ville have været kasseret kan gemmes og bruges til assisteret reproduktiv teknologi (ART). Proceduren, betydningen og de kritiske aspekter af OP-IVM er beskrevet i denne artikel.

Indtil december 2019 blev OP-IVM anvendt til fertilitetsbevarelse af 274 patienter. Embryologiske og reproduktive resultater af 158 patienter mellem 2014 og 2016 blev offentliggjort i et tidligere papir8. I følgende eksempel diskuteres den procedure, der blev fulgt for en PCOS-patient, der fik OP-IVM i 2016. Patienten er en 28-årig diagnosticeret med primær infertilitet, venstre adnexal cyste, og PCOS. Hun modtog laparoskopisk cystektomi og OP-IVMden ...

Watch this Scientific Journal Video about OP-IVM: Combining In vitro Maturation after Oocyte Retrieval with Gynecological Surgery at JoVE.com

OP-IVM: Combining In vitro Maturation after Oocyte Retrieval with Gynecological Surgery

In vitro modning (IVM) før gynækologisk drift (OP-IVM) kombinerer IVM efter oocyt hentning med rutinemæssig gynækologisk kirurgi og tjener som en forlængelse af konventionelle IVM applikationer til fertilitet bevarelse.

OP-IVM: Kombination af in vitromodning efter oocyt-hentning med gynækologisk kirurgi

The use of in vitro maturation (IVM) before gynecological operation (OP-IVM) is an extension of conventional IVM that combines IVM following oocyte ...

Teknologien, OP-IVM, er en udvidelse af konventionel IVM-protokol, der kombinerer IVM efter oocyt hentning med rutinemæssig gynækologisk kirurgi. Det er velegnet til infertile eller subfertile kvinder, der har brug for at modtage gynækologisk kirurgi før ART behandling eller fertilitet bevarelse, polycystisk ovariesyndrom patienter med clomiphene resistens, der har brug for en laparoskopisk ovarie boring kirurgi, ufrugtbare patienter, der har behov for godartede gynækologiske operationer såsom hysteroscopic myomektomi, polypectomi, transthoracic resektion af septum, og laparoskopisk rør kirurgi, og oophorocystectomy før ART behandling, og også patienter med kræft og hæmatologisk sygdom, der modtager kemoradioterapi eller strålebehandling, de kan gøre denne operation for fertilitet bevarelse. Placer ultralyd sonde inde i skeden for at scanne og registrere antallet af follikler i begge æggestokke.Find det sted tættest på æggestokken som punkteringsstedet, undgå tarmen, blæren og store blodkar. Vask 19 gauge enkelt lumen aspirationsnålen med et pH-stabilt håndteringsmedium, og indsprøjt derefter nålen i æggestokkene under vejledning af ultralyd. Aspirat follikulær væske med nålen under et tryk på 80 til 90 millimeter kviksølv, dreje nålen lidt for at aspirere så meget follikulær væske som muligt.Brug heparin til at reducere follikulær væske viskositet under aspiration. Juster sondens position for at holde den så tæt som muligt på æggestokkene på alle tidspunkter og tryk vaginal fornix med den rette kraft for at reducere skader og blødning. Sørg for at fuldføre follikulær væske aspiration inden for 25 til 30 minutter.Træk nålen ud efter endt i en æggestok, vask nålen med håndteringsmediet, og punkter den anden side ved hjælp af samme metode. Arbejder i en 37 grader Celsius homotermisk flad, forberede håndtering medier, Petri parabol, og celle si. Skyl kulturrøret og sien med forvarmede pH-stabile håndteringsmedier.Filtrer den indsugningssækkevæske med en 70 mikrometer nyloncelles si, der gentagne gange skyller kulturrøret og si med forvarmet pH-stabilt håndteringsmedium. Sørg for, at alle umodne COCs overføres fuldstændigt til kulturskålen. Overfør blodet til rene håndteringsmedier.Overfør derefter celles si til en ny skål og vask den. Aspirere og overføre håndteringsmedierne med COCs, granulosa celler og væv til en ny skål. Undersøg COCs under stereoskopet med 40 gange forstørrelse.Overfør hurtigt umodaturerne til et forvarmet IVM oocyt medium. Dernæst undersøge COCs i blodproppen og i cellesien. Overfør COCs og håndtering medier i forvarmet IVM oocyt medium.Kultur de umodne COCs i 28 til 32 timer ved 37 grader Celsius i befugtet luft, der indeholder 5% kuldioxid og 5% ilt. I december 2019 var OP-IVM blevet anvendt til fertilitetsbevarelse af 274 patienter. Et eksempel var en 28-årig patient, der blev diagnosticeret med primær infertilitet, venstre adnexal cyste, og PCOS.Hun modtog laparoskopisk cystektomi og OP-IVM i september 2016, og der blev opnået 27 umodne COCs. Efter 28 timer i kultur blev syv oocytter i MII-stadiet udvalgt og befrugtet af ICSI. Efter fem dage blev to blastocyster frosset.Den ene blev optøet i februar 2017 og overført til livmoderen. Patienten leverede en sund pige i november. OP-IVM blev først anvendt på oocyt hentning af ufrugtbare kvinder med PCOS, der gennemgår ovarieboring operation, og nu dens applikationer kan udvides til subfertile kvinder, der har brug for at modtage godartet gynækologisk operation, selv kræft kvinder for fertilitet bevarelse.Det indikerer, at anvendelsesområdet for IVM kan udvides ved at kombinere det med andre traditionelle gynækologiske operationer til kvindelig fertilitetsbevarelse.

Research

JoVE Journal

Medicine

Step By Step: Microsurgical training method combining two nonliving animal models

Trin for trin: Microsurgical træningsmetode kombinerer to ikke levende dyremodeller

The learning of microsurgical techniques and the maintenance of microsurgical skills have been traditionally based on the use of living animals, mainly ...

A Case Series of Successful Abdominal Closure Utilizing a Novel Technique Combining a Mechanical Closure System with a Biologic Xenograft that Accelerates Wound Healing

En Case serie af vellykket abdominal lukning udnytte en roman teknik kombinere en mekanisk lukning system med en Biologic xenograft, der accelererer sårheling

In the acute setting, once intra-abdominal injuries have been addressed, the next great hurdle is restoring a functional and intact abdominal compartment. ...

Evaluation of Patients' Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis

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This protocol provides guidance on how to perform high resolution video rasterstereography and treadmill gait analysis on patients after lumbar fusion ...

Structured Motor Rehabilitation After Selective Nerve Transfers

Struktureret motorisk rehabilitering efter selektive nerve overførsler

After severe nerve injuries, selective nerve transfers provide an opportunity to restore motor and sensory function. Functional recovery depends both on ...

A Rat Carotid Artery Pressure-Controlled Segmental Balloon Injury with Periadventitial Therapeutic Application

En rotte halspulsåren Tryk-kontrolleret segmental ballon skade med Periadventitial Terapeutisk Application

Cardiovascular disease remains the leading cause of death and disability worldwide, in part due to atherosclerosis. Atherosclerotic plaque narrows the ...

Combining Augmented Reality and 3D Printing to Display Patient Models on a Smartphone

Kombination af Augmented Reality og 3D-udskrivning for at vise patient modeller på en smartphone

Augmented reality (AR) has great potential in education, training, and surgical guidance in the medical field. Its combination with three-dimensional (3D) ...

In vitro Assessment of Cardiac Reprogramming by Measuring Cardiac Specific Calcium Flux with a GCaMP3 Reporter

In vitro vurdering af hjerte omprogrammering ved måling af hjertespecifik calciumflux med en GCaMP3 Reporter

Cardiac reprogramming has become a potentially promising therapy to repair a damaged heart. By introducing multiple transcription factors, including ...

Combining 3D-Printing and Electrospinning to Manufacture Biomimetic Heart Valve Leaflets

Kombination af 3D-udskrivning og elektrospinding til fremstilling af biomimetiske hjerteklapfoldere

Electrospinning has become a widely used technique in cardiovascular tissue engineering as it offers the possibility to create (micro-)fibrous scaffolds ...

Fertility Sparing Procedure using Carbon Dioxide Fiber Laser Vaporization of Ovarian Endometrioma

Fertilitetsbesparende procedure ved hjælp af kuldioxidfiberlaserfordampning af ovarieendometriom

The surgical management of endometrioma is still a matter of debate. Cystectomy, which is recognized as the standard technique, seems to be associated ...

Laparoscopic Oocyte Retrieval and Cryopreservation during Vaginoplasty for Treatment of Mayer-Rokitansky-Kuster-Hauser Syndrome

Laparoskopisk oocythentning og kryopræservering under vaginoplastik til behandling af Mayer-Rokitansky-Kuster-Hausers syndrom

In Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKHS) patients who are scheduled for laparoscopic vaginoplasty and have a desire for biological motherhood, ...