Oocyte Retrieval during Laparoscopic Vaginoplasty to Reduce Invasiveness in the Treatment of Mayer-Rokitansky-Küster-Hauser Syndrome: Journal of Minimally Invasive Gynecology

M. Candiani, V.S. Vanni, E. Papaleo, D. Delprato, I. Tandoi, V. Gervasio, M. Parma, L. Corti, S. Girardelli, L. Fedele

Research output: Contribution to journalArticlepeer-review

Abstract

Study Objective: To evaluate the treatment of patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome with a combination of oocyte retrieval and surgical vaginoplasty in a single laparoscopic procedure. Design: A case series. Setting: The study was conducted at 2 tertiary referral facilities for MRKH syndrome in Milan, Italy, between July 2017 and September 2018. Patients: Eleven patients presented with MRKH and required surgical vaginoplasty while expressing a desire for future fertility. Interventions: Two experienced surgeons and an expert in assisted reproductive technology performed concomitant vaginoplasty according to the modified technique of Davydov and laparoscopic oocyte retrieval for gamete cryopreservation. Measurements and Main Results: Before the procedure, patients underwent extensive counseling and gave written consent. At the start of surgery, 10.4 ± 4.4 (mean ± standard deviation [SD]) oocytes were retrieved laparoscopically, and 8.8 ± 3.1 (SD) mean mature oocytes were cryopreserved. After oocyte retrieval, the steps of the modified Davydov technique were followed. The total operative time was 116 ± 16 minutes (mean ± SD), and no intraoperative/postoperative complications were observed. Conclusion: This is the first report of combined oocyte retrieval and vaginoplasty for patients with MRKH syndrome. The approach was found to be feasible in patients with a desire for future fertility. It is our belief that physicians treating patients with MRKH should refer patients to centers with expertise in both vaginoplasty and assisted reproductive technology. © 2019
Original languageEnglish
Pages (from-to)74-79
Number of pages6
JournalJ. Minimally Invasive Gynecol.
Volume27
Issue number1
DOIs
Publication statusPublished - 2020

Keywords

  • Assisted reproductive technology
  • Davydov technique
  • Gamete cryopreservation
  • Mayer-Rokitansky-Küster-Hauser syndrome
  • estradiol
  • gonadorelin antagonist
  • progesterone
  • recombinant follitropin
  • abdominal radiography
  • Article
  • clinical article
  • cryopreservation
  • female
  • follicular phase
  • follow up
  • gamete
  • hormone determination
  • human
  • infertility therapy
  • Italy
  • karyotyping
  • laparoscopic surgery
  • oocyte retrieval
  • patient counseling
  • pelvis radiography
  • postoperative care
  • Rokitansky syndrome
  • tertiary care center
  • vagina reconstruction
  • adolescent
  • adult
  • clinical trial
  • congenital disorder
  • disorder of sex development
  • feasibility study
  • fertility preservation
  • gynecologic surgery
  • laparoscopy
  • Muellerian duct
  • multicenter study
  • multimodality cancer therapy
  • operation duration
  • ovulation induction
  • peroperative complication
  • postoperative complication
  • procedures
  • reconstructive surgery
  • vagina
  • young adult
  • 46, XX Disorders of Sex Development
  • Adolescent
  • Adult
  • Combined Modality Therapy
  • Congenital Abnormalities
  • Cryopreservation
  • Feasibility Studies
  • Female
  • Fertility Preservation
  • Follow-Up Studies
  • Gynecologic Surgical Procedures
  • Humans
  • Intraoperative Complications
  • Laparoscopy
  • Mullerian Ducts
  • Oocyte Retrieval
  • Operative Time
  • Ovulation Induction
  • Postoperative Complications
  • Reconstructive Surgical Procedures
  • Vagina
  • Young Adult

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