Zusammenfassung
Bei Patientinnen mit kongenitaler Zervixatresie ist die Chance auf eine Spontankonzeption auch nach erfolgreicher Rekonstruktion des Genitaltrakts reduziert. Hier bietet der Einsatz der assistierten Reproduktionstechniken eine wertvolle Option, einer Patientin eine Schwangerschaft zu ermöglichen. Ist ein Embryotransfer in das Cavum uteri transzervikal nicht durchführbar, hat neben dem transmyometrialen Embryotransfer der laparoskopische intratubare Transfer klinische Bedeutung – trotz seiner Invasivität. Der Stellenwert des intratubaren Embryotransfers bei wiederholtem Implantationsversagen, für die ältere Kinderwunschpatientin und den Kryoembryotransfer wird kontrovers diskutiert. In diesem Fallbericht wird die Lebendgeburt nach laparoskopischem intratubarem Tag-3-Kryoembryotransfer bei einer Patientin mit kongenitaler Zervixatresie mit nachfolgender Spontankonzeption beschrieben.
Abstract
In patients with congenital cervical atresia the chance of spontaneous conception is reduced, even after successful reconstruction of the genital tract. The use of assisted reproductive techniques provides a valuable option to allow patients to become pregnant. If transcervical embryo transfer to the uterine cavity cannot be performed, in addition to transmyometrial embryo transfer, laparoscopic intrafallopian transfer is also of clinical importance, despite being an invasive procedure. The importance of intratubal embryo transfer in cases of repeated implantation failure, for older patients and for frozen thawed embryo transfer is controversially discussed. This case report describes a live birth after laparoscopic intratubal frozen thawed embryo transfer on day 3 in a patient with congenital cervical atresia and a subsequent spontaneous conception.
This is a preview of subscription content, log in via an institution to check access.
Literatur
Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology (2011) The Istanbul Consensus Workshop on Embryo Assessment: proceedings of an expert meeting. Reprod Biomed Online 22(6):632–646
Anttila L, Pettilä TA, Suikkari AM (1999) Successful pregnancy after in-vitro fertilization and transmyometrial embryo transfer in a patient with congenital atresia of cervix. Hum Reprod 6:1647–1649
Deffarges JV, Haddad B, Musset R, Paniel BJ (2001) Utero-vaginal anastomosis in women with uterine cervix atresia: long-term follow-up and reproductive performance. A study of 18 cases. Hum Reprod 16(8):1722–1725
Devroey P, Braeckmans P, Smitz J et al (1986) Pregnancy after translaparocopic zygote intrafallopian transfer in a patient with sperm antibodies. Lancet 1:1329
Gardner DK, Lane M, Calderon I, Leeton J (1996) Environment of the preimplantation human embryo in vivo: metabolite analysis of oviduct and uterine fluids and metabolism of cumulus cell. Fertil Steril 65:349–353
Gat I, Levron J, Yerushalmi G, Dor J, Brengauz M, Orvieto R (2014) Should zygote intrafallopian transfer be offered to all patients with unexplained repeated in-vitro fertilization cycle failures? J Ovarian Res 7:1757–2215
Grimbizis GF, Tsalikis T, Mikos T, Papadopoulos N, Tarlatzis BC, Bontis J (2004) Successful end to end cervical anastomosis in a patient with congenital cervical fragmentation: case report. Hum Reprod 5:1204–1210
Habana AE, Palter SF (2001) Is tubal embryo transfer of any value? A meta-analysis and a comparison with the Society for Assisted Reproductive Technology database. Fertil Steril 76:286–293
Jamal W, Philipps SJ, Hemmings R, Lapensee L, Couturier B, Bisonette F, Kadoch IJ (2009) Successful pregnancy following novel IVF protocol and transmyometrial embryo transfer after radical vaginal trachelectomy. Reprod Biomed Online 18:700–703
Kato O, Takatsuka R, Asch RH (1993) Transvaginal-transmyometrial embryo transfer: the Towako method; experiences of 104 cases. Fertil Steril 59:51–53
Khairy M, Shah H, Rajkhowa M (2016) Transmyometrial versus very difficult transcervical embryo transfer: efficacy and safety. Reprod Biomed Online 32(5):513–517
Lai TH, Wu MH, Hung KH, Cheng YC, Chang FM (2001) Successful pregnancy by transmyometrial and transtubal embryo transfer after IVF in a patient with congenital cervical atresia who underwent uterovaginal canalization during Caesarean section: case report. Hum Reprod 16(2):268–271
Levran D, Mashiach S, Dor J, Levron J, Farhi J (1998) Zygote intrafallopian transfer may improve pregnancy rate in patients with repeated failure of implantation. Fertil Steril 69(1):26–30
Ménézo Y, Guérin P, Elder K (2015) The oviduct: a neglected organ due for re-assessment in IVF. Reprod Biomed Online 30(3):233–240
Murray A, Hutton J (2011) Successful tubal blastocyst transfer after laparocopic cervical cerclage: cesarean delivery of a live very low-birth-weight infant and later hysterectomy for uterine rupture. Fertil Steril 96(4):895–897
Nakagawa K, Juen H, Nishi Y, Sugiyama R, Motoyama H, Kuribayashi Y, Inoue M, Akira S, Sugiyama R (2014) Advanced scheduling for zygote intrafallopian transfer is possible via the use of a hormone replacement cycle for patients who have experienced repeated implantation failures. Arch Gynecol Obstet 290(5):1031–1035
Rock JA, Roberts CP, Jones HW (2010) Congenital anomalies of the uterine cervix: lessons from 30 cases managed clinically by a common protocol. Fertil Steril 94(5):1858–1863
Seibel MM, Weissman A (2009) Gamete intrafallopian transfer (GIFT) and zygote intrafallopian transfer (ZIFT). In: Gardner DK, Weismann A, Howles CM, Shoham Z (Hrsg) Textbook of assisted reproductive technologies: laboratory and clinical perspectives, 3. Aufl. Taylor and Francis, London, S 673–691
Shahrokh Tehraninejad E, Azimi Nekoo E, Ghaffari F, Hafezi M, Karimian L, Arabipoor A (2015) Zygote intrafallopian tube transfer versus intrauterine cleavage or blastocyst stage transfer after intracytoplasmic sperm injection cycles in patients with repeated implantation failure: A prospective follow-up study. J Obstet Gynaecol Res 41(11):1779–1784
Thijssen R, Hollander J, Willemsen W, van der Heyden P, van Dongen P, Rolland R (1990) Successful pregnancy after Zift in a patient with congenital cervical atresia. Obstet Gynecol 76:902–904
Van Voorhis BJ, Syrop CH, Vincent RD Jr et al (1995) Tubal versus uterine transfer of cryopreserved embryos: a prospective randomized trial. Fertil Steril 63:578–583
Weissman A, Eldar I, Ravhon A, Biran G, Farhi J, Nahum H, Golan A, Levran D (2007) Timing intra-Fallopian transfer procedures. Reprod Biomed Online 4:445–450
Weissman A, Horowitz E, Ravhon A, Nahum H, Golan A, Levran D (2013) Zygote intrafallopian transfer among patients with repeated implantation failure. Int J Gynaecol Obstet 120(1):70–73
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Interessenkonflikt
A.B. Brössner und J. Kleinstein geben an, dass kein Interessenkonflikt besteht.
Das Einverständnis der Patientin zur Veröffentlichung der Daten liegt vor.
Additional information
Redaktion
R. Felberbaum, Kempten
A. Germeyer, Heidelberg
Rights and permissions
About this article
Cite this article
Brössner, A.B., Kleinstein, J. Laparoskopischer intratubarer Kryoembryotransfer bei kongenitaler Zervixatresie. Gynäkologische Endokrinologie 15, 87–92 (2017). https://doi.org/10.1007/s10304-016-0101-3
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10304-016-0101-3
Schlüsselwörter
- Verfahren der assistierten Reproduktion
- Transmyometrialer Embryotransfer
- Implantationsversagen
- Endometriose
- In-vitro-Fertilisation