The A fertilization process comprises includes the following steps: a) a container (15) which can be introduced into, and lodged in, the uterine cavity of the mammal is provided; b) the container (15) is filled with a culture medium, at least one ovocyte of the mammal, and spermatozoa; c) the filled container (15) is inserted into the uterine cavity; d) the container (15) is left for a given length of time to allow fertilization of the ovocyte(s) to take place; e) the contents of the container (15) are released into the uterine cavity. The container may be made from a tube of biodegradable or non-biodegradable material. In the latter case, it is associated with a stiffening device. A biodegradable container (15) filled with gametes and a culture medium is placed in the uterine cavity using an implantation device (20) which is then withdrawn from the mammal's genital tract.
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9. device A device for intra-uterine fertilization in mammals comprising a container means sized for introduction and lodging in the uterine cavity of a mammal and for containing a culture medium and at least one ovocyte of the mammal and spermatozoa while introduced into and lodged in the uterine cavity of the mammal for a time period sufficient to allow fertilization of the at least one ovocyte, said container means including means for defining an exit area to allow access to the uterine cavity from the container means without removal thereof from the uterine cavity and enabling transfer of the at least one fertilized ovocyte from the container means into the uterine cavity without removal thereof from the uterine cavity between fertilization and transfer .
1. process A process of intra-uterine fertilization in mammals comprising the following steps:
a) providing a container of a size suitable for introduction and lodging in the uterine cavity of a mammal and having an exit area;
b) filling the container with culture medium, at least one ovocyte of the mammal and spermatozoa;
c) introducing and lodging the filled container in the uterine cavity;
d) leaving the container lodged in the uterine cavity for a specified period of time to allow fertilization of the at least one ovocyte therein; and
e) accessing the uterine cavity through the exit area of the container without removal of the container from lodged in in the uterine cavity to enable transfer of the at least one fertilized ovocyte directly from the container through the exit area into the uterine cavity without removal of the at least one fertilized ovocyte from the uterine cavity between fertilization and transfer .
23. device A device for intra-uterine fertilization in mammals comprising a tube means sized for introduction through the neck of the uterine cavity uterus of the mammal into the uterine cavity and for accommodating culture medium, at least one ovocyte and spermatozoa of the mammal while lodged in the uterine cavity for a time sufficient to allow for fertilization of the at least one ovocyte therein, a piston means disposed proximate one end of the tube means , said piston means being mounted for sliding movement towards the other end of the tube means , holding means for a tube holder to removably holding hold the device in the neck of the uterine cavity uterus and for lodging the tube means in the uterine cavity, and means an exit area proximate the other end of the tube means adapted to face the back of the uterine cavity, said for defining an exit area to allow access to the uterine cavity without removing the tube means from the uterine cavity and enabling transfer of the being adapted to accommodate culture medium, at least one fertilized ovocyte, and spermatozoa for intra-uterine fertilization therein, from the tube means into the uterine cavity without removal thereof from the uterine cavity between fertilization and transfer, said piston means being movable toward the other end to expel the at least one fertilized ovocyte from said tube means .
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In order to overcome the disadvantages of the prior art, the steps of the present invention include:
a) providing a container which can be introduced into and lodged in the uterine cavity of the mammal;
b) filling the container with a culture medium, at least one ovocyte of the mammal and spermatozoa;
c) inserting the filled container into the uterine cavity;
d) leaving the container for a specific period of time to allow fertilisation of the ovocyte(s) therein;
e) allowing the contents of the container to escape into the uterine cavity.
This method avoids in particular the final step of embryo transfer from outside the mammal to the interior of the uterine cavity.
According to a preferred feature of the process of the invention, said escape is effected by ejecting the container contents into the back of the uterine cavity in order to increase the chances of implantation of fertilise ovocytes or embryos.
For the same reasons, if the container is of biodegradable-material it is still preferable to insert it towards the back of the uterus.
This process requires a container of a size which is suitable for introduction into and lodging in the uterine cavity of a mammal. It must be much smaller than a container for the FIVETE technique, particularly for human females, as the neck of the human uterus has an opening of only a few millimeters.
The method described above has been developed by the Applicant in work conducted since December 1986 in the form of preliminary studies involving a process comprising the following steps:
1. providing a fine tube having a capacity of about 250 microliters;
2. filling the tube with a culture medium, at least one human ovocyte and mobile human spermatozoa;
3. closing at least one end of the tube and immersing the other end in a receptacle containing culture medium;
4. placing the filled tube and its receptacle in an oven at 37.degree. C. for 20 to 30 hours;
5. collecting the embryos and placing them in culture medium in the incubator at 37.degree. C. until the following day;
6. replacing one or more embryos in the uterine cavity of the patient using a Frydman catheter.
The embryo(s) are replaced 44 to 50 hours following filling the tube with the mixture of culture medium, ovocyte(s) and spermatozoa.
These preliminary studies showed that in tests covering 57 ovocytes 33 were fertilised to give embryos for replacement (a cleavage rate of about 58%), whilst of 88 ovocytes removed in similar manner followed by in vitro fertilisation (IVF) or intravaginal culture (IVC), 44 embryos for replacement were produced, i.e. a cleavage rate of 50%. Two pregnancies can certainly be attributed to replacement of fine tube fertilised ovocytes.
These preliminary studies showed that up to four human ovocytes can be fertilised in a fine tube of this kind. It has been shown that fine tube fertilisation of this kind requires an average volume of culture medium per ovocyte of only about 60 microliters, containing 600 to 1,200 mobile spermatozoa. The culture medium used in these studies was MENEZZO culture medium B2.
It is made from animal or vegetable polymer, particularly a hydrophilic polymer, for example collagen, fibrinogen or a polymeric sugar.
Tube 11 is slid into a footed test tube 14 which has an internal diameter substantially equal to the external diameter of tube 11 and which acts as a support.
The footed test tube may be made of a low friction material, for example polytetrafluorethylene or polyethylene, and is slightly shorter than closed tube 11.
The container may be filled in the normal manner using a syringe where the internal diameter of the needle is greater than that of the ovocyte.
Tube 10 may also be filled by aspiration to produce the filled tube of
Tube 10, open at both ends, is inserted in an elongate hollow support cylinder having an internal diameter equal to that of test tube 14 from
When knot 18 is tied some excess fluid remains in the frustoconical section 19 of tube 10 above the upper knot.
The thickness of wall 10 of biodegradable material tube 10 of course determines the time lapse before the contents of the container can escape into the uterine cavity. In the process according to the invention, this wall must disintegrate a certain time after introduction of the sausage-like container 15 from
The container material must be resorbable and non-immunogenic. In this instance the container has a wall of a single thickness but it is also possible to employ a biodegradable container having walls of different thickness.
The mammalian uterus provides a warm humid environment in the uterine cavity, but without any high enzymatic activity which will provoke degradation of a biodegradable material.
On the other hand, mobile mammalian spermatozoa are highly active enzymatically and may attack the inside of wall 100 of container 15 sufficiently to degrade and burst it.
In order to determine the wall thickness required for escape of the contents after a specified period of between 15 and 55 hours, for example, the following in vitro test is conducted.
A container having wall thickness E is produced and filled as shown in
This container when filled in this way is placed in an incubator saturated with water vapour at about the internal temperature of the mammal. The state of the container is observed regularly and the time at which the contents spontaneously escape from the container is noted. If this time is greater than 55 hours a further container is produced having walls thinner than E, for example 0.5E, and the above in vitro test carried out on this container. Using an iterative method a thickness of wall 100 can be obtained which produces the desired in vitro degradation time, for example 15 to 55 hours.
Wall 100 of biodegradable material tube 10, 11 may have a thickness of between 0.01 and 1 mm.
Tests have shown that MENEZZO culture medium B2 containing 10,000 to 20,000 spermatozoa per milliliter degrades in this in vitro test a cured collagen wall 0.1 mm thick in over 72 hours and a gelose wall 0.1 mm thick, as used in gastroresistant capsules, in 15 minutes.
At its lower end cylindrical tube 21 comprises a rounded edge 22 which slightly reduces the diameter of the orifice in order to retain tube 15 and prevent it from sliding out. Towards its upper end tube 21 has an external screwthread 23 onto which end 24 of a cylindrical tube 25 is screwed, tube 25 having inside it a piston 26 which slides with low friction and is fixed to shaft 27. The internal diameter of cylinder 25 is equal to that of tube 21 to allow continuity of sliding movement of piston 26 in cylindrical tube 21.
Tube 21 is introduced into the uterine cavity so as to leave sufficient depth for filled container 15 to lodge therein, and piston 26 then is pushed using shaft 27 which protrudes from the body of the mammal, as does cylindrical tube 25. This deposits container 15 near the back of the uterus. The implantation device 20 is then withdrawn from the uterus and vagina of the mammal and the contents of filled container 15 escape after a period determined by biodegradation of at least one part of the container.
The tube 110 has a thin wall 100, common area 42 being thicker.
Like tube 10, tube 110 may be filled by aspiration of a culture medium containing spermatozoa and at least one ovocyte.
Support 114 is slightly shorter than container 115.
In addition, support 114 can be separated into two shells 114A to release container 115.
The tube is flexible and unbreakable to enable it to deform during its difficult passage through the neck of the uterus and to adapt to the internal shape of the uterine cavity of the mammal. Tube 201 has a so-called upper open end 202 which may be closed by a small plug (not shown) of biodegradable material, for example collagen, fibrinogen or a polymeric sugar.
Open end 202 has a restricted orifice 212 as compared with the internal diameter of tube 201.
The other, so-called lower end 203 of the tube is closed by a plug 204 which forms a watertight piston inside tube 201.
Tube 201 has a length about equal to the depth of the uterine cavity of the mammal.
For a patient tube 201 may be between 5 and 7 cm long and have an exterior diameter of up to 3 mm to enable it to be slid into the uterine cavity through the neck of the uterus without causing any trauma.
Tube 201 is fixed to holding device 220 over a portion of its length near its lower end 203 by means of a longitudinal bore 221 passing through the holding device.
Holding device 220 comprises, in longitudinal succession, a first section 222 which can be introduced into the neck of the uterus and a second section 223 which can be located in the vagina external to and abutting the cervix. The first section comprises a radially expansible element 222A having a rest position for insertion into the cervix and a second position in which it presses against the internal walls of the neck of the uterus.
Expansible element 222A is formed of thin walled flexible material which can expand radially into the second position.
The expansible element comprises at least two longitudinal tangs 222B each having a movable lower end 222C and an upper end 222D which is fixed longitudinally relative to tube 201.
Holding device 220 further comprises a mobile portion 223A for controlling the longitudinal position of the lower end 222C of expansible element 222A and a portion 222E which is fixed relative to tube 201 and on which mobile portion 223A can move.
In more detail, fixed portion 222E comprises a longitudinal cylindrical extension 224 forming part of said first section 222 of holding device 220. Screwthread 207 is carried on the external surface of extension 224.
Cylindrical extension 224 is formed in one piece with a cylindrical sleeve 205 of greater diameter. Where they join, a shoulder 225 is formed on the upper external surface of sleeve 205.
Extension 224 and sleeve 205 are formed with a first bore 221 having a slightly smaller diameter than the external diameter of tube 201 so that the latter can be forced into the bore and retained therein.
Sleeve 205 comprises a second bore 226 having a larger diameter than the outside diameter of tube 201, the first bore opening into the second through a frustoconical cavity 227.
Second bore 226 has a depth and diameter sufficient to receive a pusher device for displacing plug 204 in tube 201.
Mobile portion 223A comprises a knurled disc 208 which can screw onto screwthread 207 because it has a complementary screwthread 207A.
Thus fixed section 222B and mobile section 223A comprise complementary screwthreads 207, 207A to allow the mobile section to turn and to move longitudinally relative to the fixed section.
Tube 201 comprises a welded collar 211 which substantially abuts the top of cylindrical extension 224.
Each tang 222B is fixed at its lower end 222C lower ring 209 and at its upper end to welded collar 211. The upper end of expansible element 222A is therefore fixed to collar 211 welded to tube 201. Each tang is very slightly curved with its concave side oriented towards cylindrical extension 224.
Thus if ring 209 and collar 211 are brought closer together the curvature of the tangs 222B, their radial extension and flexion increase.
The upper end 222D of expansible element 222A is attached to the upper end of cylindrical extension 224 of fixed portion 222E. This eliminates the need for the welded collar of the preceding embodiment.
Longitudinal bore 321 through holding device 320 has a diameter which is slightly greater than the external diameter of tube 201 so that the latter can be joined to fixed part 222E by adhesive 300.
Lower ring 309 which rests on knurled disc 208 has a slightly smaller diameter to that of ring 209 from the preceding figure, but it is still slidable longitudinally on cylindrical extension 224.
Orifice 212 at the upper end 202 of tube 201 is closed by a plug 301 of biodegradable material the same as that described above. The shape of the plug is such that it can be readily expelled when the liquid contents of the container are ejected on upward displacement of piston 204 inside the tube towards the upper end 202 of tube 201.
Tube 201 comprises a welded collar 211 attached to the upper end 222D of each tang 222B, the lower ends 222C of which are fixed to a ring 409 which is slidable on tube 201.
In this preferred embodiment, the cylindrical extension of the preceding embodiments is dispensed with.
Holding device 420 comprises a cylindrical sleeve 405 comprising, starting from its upper circular surface 410, an axial bore 421 having a depth of about half the longitudinal height of sleeve 405.
The diameter of bore 421 of length 1 is about the same as the external diameter of tube 201 and enables sleeve 405 to be fixed to the corresponding lower end of tube 201 over a length 1 by glue 400.
Bore 421 opens into a longitudinal bore 226 through a frustoconical portion 227. Bore 226 opens into the lower circular surface 424 of sleeve 405. As in the embodiments of
Aligned with and extending from the lower surface 424 of sleeve 405 is a flange 430 to facilitate handling.
A screwthread 431 is provided over the full height of the outer cylindrical surface of sleeve 405. It stops near the base of shoulder 432 formed by flange 430.
Screwed on sleeve 405 is a bush 435 whose internal cylindrical surface carries a screwthread 436 complementary to screwthread 431 on sleeve 405.
The longitudinal depth of bush 435 is substantially equal to the height of the sleeve less the height of flange 430.
The top of bush 435 is in one piece with and closed by a knurled disc 437. The disc diameter is greater than that of the bush to facilitate manipulation of the knurled disc. Disc 437 comprises a cylindrical axial passage 438 whose diameter is slightly greater than the external diameter of tube 201 to permit sliding contact. To facilitate equilibrium of the pressure in the cavity defined between circular surface 410 of sleeve 405 and the base of bush 435 defined by disc 437, a hole 440 is provided in the cylindrical wall of bush 437 in the immediate vicinity of the base.
Thus in this embodiment, fixed section 422E and mobile section 423A comprise complementary screwthreads 431, 436 so that the mobile section can turn and mvoe longitudinally relative to the fixed section.
Screwthreads 431, 436 are respectively on an external cylindrical surface of fixed section 422E and on an internal cylindrical surface of a bush 435 on mobile section 423A.
This flange 450 is intended to increase the integrity of tube 201 with sleeve 405 by preventing longitudinal displacement of the tube from bore 226 into bore 421A. In this case the tube is simply crimped into bore 421A.
The fertilisation process using the device of
If plug 204 is a tripartite plug of a type used in French CASSOU tubes, a syringe connector is inserted in bore 226 of sleeve 205 and culture medium, ovocyte(s) and spermatozoa are sucked into container 215 consisting of tube 201, via its upper end 202.
If the plug is not a tripartite plug the same contents can be introduced into tube 201 using a syringe and needle.
If required, the tube is then plugged at its upper end 202 using a plug of biodegradable material (not shown in FIGS. 7 and 8).
The device constituted by container 215 and its holding device 220 is introduced into the vagina of the mammal.
End 202 of tube 201 is introduced into the neck of the uterus and the device is pushed in until knurled disc 208 abuts the neck of the uterus.
Sleeve 205 is then held against rotation using forceps (not shown) and knurled disc 208 is moved away from shoulder 225 by turning it on screwthread 207, thus increasing the flexion of the two tangs 222B which then press against the internal walls of the neck of the uterus, thus removably fixing the holding device 220 of container 215 in the neck of uterus.
Shaft 501 has a smaller diameter than the internal diameter of tube 201 and its length is such, in relation to the lengths of casing 502, plug 204 and tube 201, that plug 204 cannot pass out of tube 201 through its end 202. The restricted orifice 212 also acts as a security measure to keep the plug in the tube.
Knurled disc 208 is then unscrewed to release tangs 222B and free holding device 220. The apparatus is then removed from the genital tract of the mammal.
The holding devices have been described with reference to
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