目的:为了证明体外成熟(IVM)治疗的临床技术,包括刺激建议,小卵泡拾取程序,和紧凑的卵丘-卵母细胞复合体(COC)搜索实践。
方法:该视频利用手术和胚胎学实践中的实景镜头进行了代表性的IVM治疗周期,提供有关实践程序的分步说明和建议。
方法:体外受精(IVF)诊所。
方法:接受IVM治疗的患者。该视频中包含的患者同意发布视频并在线发布视频,包括在社交媒体上,期刊网站,科学文献网站,和其他适用的网站。
方法:确定治疗队列,IVM定义,以及刺激治疗的建议。从小的窦卵泡中提取COC技术的视觉演示包括管道,针头类型,使用双腔或鞘针时的注意事项,针头压力,超声,针头冲洗,和抽吸技术。卵母细胞搜索和IVM制备的视觉演示,包括过滤卵泡抽吸物,防止COC冷却,紧凑型COCs的识别,以及不同IVM方法的一般参数。
方法:用于IVM治疗的小卵泡卵拾取和紧凑COC鉴定的临床技术。
结果:使用最小的卵巢刺激可以成功治疗患者的IVM,有效的小卵泡检索,和有效的紧凑COC识别,方法灵活,取决于临床限制和偏好。
结论:对于接受IVF治疗的高卵巢储备和高反应患者,体外成熟治疗是一种有效且安全的治疗方法,其中多个未成熟COCs的回收及其离体成熟可以在很少或没有体内刺激的情况下实现。实践程序在治疗中心和IVM技术之间有所不同。该视频提供了实践建议,并结合了技术的视觉演示,以帮助标准化方法并将实践扩展到更多中心。
OBJECTIVE: To demonstrate clinical techniques for in vitro maturation (IVM) treatment, including stimulation recommendations, small follicle pick-up procedures, and compact cumulus-oocyte complex (COC) search practice.
METHODS: This video utilizes live-action footage from surgery and embryology practice for a representative IVM treatment cycle, with step-by-step instructions and recommendations for practice procedures.
METHODS: In vitro fertilization (IVF) clinic.
METHODS: Patients undergoing IVM treatment. The patient(s) included in this video gave consent for publication of the video and posting of the video online, including on social media, the journal website, scientific literature websites, and other applicable sites.
METHODS: Identification of treatment cohorts, IVM definitions, and recommendations for stimulation treatments. A visual demonstration of COC extraction techniques from small antral follicles includes tubing, needle types, considerations when using double lumen or sheath needles, needle pressure, ultrasound, needle flushing, and aspiration technique. Visual demonstration of oocyte search and IVM preparation, including filtering follicular aspirate, prevention of COC cooling, identification of compact COCs, and general parameters of different IVM approaches.
METHODS: Clinical techniques for small follicle ovum pick up and compact COC identification for IVM treatment.
RESULTS: Successful IVM treatment of patients can be achieved using minimal ovarian stimulation, effective small follicle retrieval, and efficient compact COC identification with flexibility in approach depending on clinical constraints and preference.
CONCLUSIONS: In vitro maturation treatment is an efficacious and safe treatment for high ovarian reserve and hyper-responding patients undergoing IVF treatment, in which the retrieval of multiple immature COCs and their ex vivo maturation can be achieved with little to no in vivo stimulation. Practice procedures vary between treatment centers and IVM techniques. This video provides practice recommendations paired with a visual demonstration of techniques to assist in standardizing the approach and expanding the practice to more centers.