Novel uterine lavage system for recovery of human embryos fertilized and matured in vivo

Alexander Nadal,1 Sam Najmabadi,2,3 Bruce Addis,1 John E Buster1,41Department of Research and Development, Previvo Genetics, San Carlos, CA 94070, USA; 2Division of Reproductive Endocrinology and Infertility, Punta Mita Hospital, Punta Mita, Nayarit 63734, Mexico; 3Division of Reproductive Endocrino...

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Autores principales:	Nadal A, Najmabadi S, Addis B, Buster JE
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	in-vivo embryo uterine lavage IVF PGT-A ART Medical technology R855-855.5
Acceso en línea:	https://doaj.org/article/0960b69c0e13412882634e15628af019
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spelling	oai:doaj.org-article:0960b69c0e13412882634e15628af0192021-12-02T03:25:53ZNovel uterine lavage system for recovery of human embryos fertilized and matured in vivo1179-1470https://doaj.org/article/0960b69c0e13412882634e15628af0192019-04-01T00:00:00Zhttps://www.dovepress.com/novel-uterine-lavage-system-for-recovery-of-human-embryos-fertilized-a-peer-reviewed-article-MDERhttps://doaj.org/toc/1179-1470Alexander Nadal,1 Sam Najmabadi,2,3 Bruce Addis,1 John E Buster1,41Department of Research and Development, Previvo Genetics, San Carlos, CA 94070, USA; 2Division of Reproductive Endocrinology and Infertility, Punta Mita Hospital, Punta Mita, Nayarit 63734, Mexico; 3Division of Reproductive Endocrinology and Infertility, Center for Reproductive Health and Infertility, Beverly Hills, CA 90211, USA; 4Division of Reproductive Endocrinology and Infertility, Warren Alpert Medical School of Brown University, Providence, RI 02903, USAPurpose: In this paper we describe a novel uterine lavage system for the recovery of in vivo preimplantation embryos. Currently, no other method exists to retrieve preimplantation embryos except for in vitro fertilization (IVF).Methods: A single center, prospective feasibility study was conducted to test a novel uterine lavage system for the recovery of in vivo preimplantation embryos in egg donors and patients seeking pregnancy. Subjects were placed on controlled ovarian hyperstimulation followed by intrauterine insemination (IUI) and uterine lavage performed approximately 4–6 days after IUI. Subjects were followed up for 30 days after the procedure to monitor for safety events.Results: A total of 134 uterine lavage cycles were performed on 81 subjects (average: 1.7 cycles/subject). Ova (oocytes or embryos) were collected in 53% (71/134) of the cycles with steady improvement of recovery efficiency over the course of the study, and embryos collected in 42% (56/134) of cycles. Embryos of many stages were collected, but 71% (96/136) of embryos collected were blastocyst stage embryos which are at the most advanced stage of embryogenesis. Embryos recovered were of good quality based on blastocyst gradings in which 74% (70/95, 1 blastocyst not graded) of the blastocysts were good quality as determined by the Gardner Scale of Morphology. The procedure was well tolerated with minor side effects. In 8% of cycles a positive hCG was observed after the lavage indicating some embryos were not recovered by the lavage system.Conclusion: Through this work the system has been shown to recover embryos from the uterus in a safe and effective manner, thus opening the possibility that uterine lavage may serve as an alternative to IVF where patient indications allow.Keywords: in vivo embryo, uterine lavage, IVF, assisted reproductive technology, blastocystNadal ANajmabadi SAddis BBuster JEDove Medical Pressarticlein-vivo embryouterine lavageIVFPGT-AARTMedical technologyR855-855.5ENMedical Devices: Evidence and Research, Vol Volume 12, Pp 133-141 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	in-vivo embryo uterine lavage IVF PGT-A ART Medical technology R855-855.5
spellingShingle	in-vivo embryo uterine lavage IVF PGT-A ART Medical technology R855-855.5 Nadal A Najmabadi S Addis B Buster JE Novel uterine lavage system for recovery of human embryos fertilized and matured in vivo
description	Alexander Nadal,1 Sam Najmabadi,2,3 Bruce Addis,1 John E Buster1,41Department of Research and Development, Previvo Genetics, San Carlos, CA 94070, USA; 2Division of Reproductive Endocrinology and Infertility, Punta Mita Hospital, Punta Mita, Nayarit 63734, Mexico; 3Division of Reproductive Endocrinology and Infertility, Center for Reproductive Health and Infertility, Beverly Hills, CA 90211, USA; 4Division of Reproductive Endocrinology and Infertility, Warren Alpert Medical School of Brown University, Providence, RI 02903, USAPurpose: In this paper we describe a novel uterine lavage system for the recovery of in vivo preimplantation embryos. Currently, no other method exists to retrieve preimplantation embryos except for in vitro fertilization (IVF).Methods: A single center, prospective feasibility study was conducted to test a novel uterine lavage system for the recovery of in vivo preimplantation embryos in egg donors and patients seeking pregnancy. Subjects were placed on controlled ovarian hyperstimulation followed by intrauterine insemination (IUI) and uterine lavage performed approximately 4–6 days after IUI. Subjects were followed up for 30 days after the procedure to monitor for safety events.Results: A total of 134 uterine lavage cycles were performed on 81 subjects (average: 1.7 cycles/subject). Ova (oocytes or embryos) were collected in 53% (71/134) of the cycles with steady improvement of recovery efficiency over the course of the study, and embryos collected in 42% (56/134) of cycles. Embryos of many stages were collected, but 71% (96/136) of embryos collected were blastocyst stage embryos which are at the most advanced stage of embryogenesis. Embryos recovered were of good quality based on blastocyst gradings in which 74% (70/95, 1 blastocyst not graded) of the blastocysts were good quality as determined by the Gardner Scale of Morphology. The procedure was well tolerated with minor side effects. In 8% of cycles a positive hCG was observed after the lavage indicating some embryos were not recovered by the lavage system.Conclusion: Through this work the system has been shown to recover embryos from the uterus in a safe and effective manner, thus opening the possibility that uterine lavage may serve as an alternative to IVF where patient indications allow.Keywords: in vivo embryo, uterine lavage, IVF, assisted reproductive technology, blastocyst
format	article
author	Nadal A Najmabadi S Addis B Buster JE
author_facet	Nadal A Najmabadi S Addis B Buster JE
author_sort	Nadal A
title	Novel uterine lavage system for recovery of human embryos fertilized and matured in vivo
title_short	Novel uterine lavage system for recovery of human embryos fertilized and matured in vivo
title_full	Novel uterine lavage system for recovery of human embryos fertilized and matured in vivo
title_fullStr	Novel uterine lavage system for recovery of human embryos fertilized and matured in vivo
title_full_unstemmed	Novel uterine lavage system for recovery of human embryos fertilized and matured in vivo
title_sort	novel uterine lavage system for recovery of human embryos fertilized and matured in vivo
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/0960b69c0e13412882634e15628af019
work_keys_str_mv	AT nadala noveluterinelavagesystemforrecoveryofhumanembryosfertilizedandmaturedinvivo AT najmabadis noveluterinelavagesystemforrecoveryofhumanembryosfertilizedandmaturedinvivo AT addisb noveluterinelavagesystemforrecoveryofhumanembryosfertilizedandmaturedinvivo AT busterje noveluterinelavagesystemforrecoveryofhumanembryosfertilizedandmaturedinvivo
_version_	1718401711664529408

Novel uterine lavage system for recovery of human embryos fertilized and matured in vivo

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