Efficacy of local aspiration in the conservative treatment of live interstitial pregnancy coexisting with live intrauterine pregnancy after in vitro fertilization and embryo transfer

Background Heterotopic pregnancy （HP） is defined as a pregnancy in which one or more embryos is viably implanted in the uterus while the other is implanted elsewhere as an ectopic pregnancy. The occurrence of HP rises dramatically with the increased use of assisted reproductive technology. HP of interstitial pregnancy is one special situation which needs more concern. Here we evaluate the efficacy of local aspiration and instillation of hyperosmolar glucose in the treatment of live interstitial pregnancy complicated with live intrauterine pregnancy after in vitro fertilization and embryo transfer. Methods Five female patients were diagnosed with live interstitial pregnancies complicated with intrauterine pregnancies. They were treated with transvaginal ultrasound-guided aspiration of interstitial pregnancy and instillation of hyperosmolar glucose at the Center for Reproductive Medicine of Peking University Third Hospital from January 1st, 2008 to May 30th, 2011. Results Gemmule embryos in all 5 cases were aspirated successfully and there was no abdominal hemorrhage, threatened abortion or infection in any of the cases. The sac of interstitial pregnancy continued to progress after aspiration and stopped growing between 11 to 20 weeks. By the 30th week of pregnancy, 80% of the interstitial masses had disappeared. Four cases have delivered and one is still in on-going pregnancy. All of the four cases underwent cesarean section and there were nothing special detected in the corner of the uterus. Conclusion Local aspiration and instillation of hyperosmolar glucose may be an effective way to treat live interstitial pregnancy when coexisting with a live intrauterine pregnancy.

水牛活体采卵体外生产胚胎技术

本研究应用B超引导阴道穿刺法,对40头尼里-拉菲和摩拉水牛连续3次采卵,采卵间隔为3d,共采卵120头次。共穿刺卵泡935个,采集卵母细胞643枚,可用卵母细胞为456枚,卵母细胞回收率为68.77%(643/935),卵母细胞可用率为70.92%(456/643),头均可用卵母细胞为(3.80±0.23)个。第1、2、3次采卵头均回收可用卵母细胞数分别为(3.82±0.50)、(3.82±0.35)、(4.05±0.43)枚,差异不显著(P>0.05)。收集的卵母细胞经体外成熟、体外受精和受精卵与颗粒细胞单层体外共培养,受精后48h分裂率为56.36%(257/456),囊胚率为20.39%(93/456)。2个品种水牛的头均可采卵泡数、头均回收卵母细胞数和囊胚率均无显著差异。这表明,在B超引导下进行连续活体采卵,并利用卵母细胞进行体外受精生产胚胎是可行的。

IVF/ICSI取卵术中两种17G取卵针不同应用效果分析

目的:探讨体外受精-胚胎移植(IVF/ICSI)取卵术中应用不同17G取卵针后的患者的胚胎发育情况和临床结局差异。方法:比较在IVF/ICSI取卵术中应用进口17G取卵针(A组,333例)和国产取卵针(B组,532例)的患者的胚胎发育情况和临床结局指标,包括穿刺卵泡数、获卵数、卵裂数、可利用胚胎数、优胚数、总受精率、阴道出血、中重度卵巢过度刺激综合征(OHSS)发生率、临床妊娠率、种植率和流产率等。结果:两组患者在穿刺卵泡数、卵裂数、可利用胚胎数、优胚数、总受精率、中重度OHSS发生率、临床妊娠率、种植率和流产率上的差异均无统计学意义(P>0.5)。结论:应用国产取卵针或进口取卵针并不影响IVF/ICSI取卵术中的患者的胚胎发育情况和临床结局。取卵针的选择应在患者耐受度、效率、经济和手术者的个人使用等方面找到良好的平衡,可结合患者实际情况、成本、有效性和取卵操作者的偏好权衡考虑以选择合适的取卵针。