Sampling needle
10765454 ยท 2020-09-08
Assignee
Inventors
Cpc classification
A61B10/0283
HUMAN NECESSITIES
International classification
Abstract
An oocyte retrieval needle is provided. The needle comprises a first tubular region in fluid communication with a second tubular region. The first tubular region comprises a sharp point leading end configured for insertion into a subject. The second tubular region comprises an open trailing end. The leading and trailing ends form respective opposite ends of the needle. Internal passages of the first and second tubular regions form a continuous open passage extending from the leading end to the trailing end. The first tubular region has an outer diameter which is less than an outer diameter of the second tubular region and the internal passage of the first tubular region has an inner, luminal diameter which is less than an inner diameter of the internal passage of the second tubular region. The oocyte retrieval needle is a double lumen needle.
Claims
1. An oocyte retrieval needle comprising a first tubular region in fluid communication with a second tubular region, the first tubular region comprising a sharp point leading end configured for insertion into a subject and the second tubular region comprising an open trailing end, the leading end and the trailing end forming respective opposite ends of the needle, wherein: internal passages of the first and second tubular regions form a continuous open passage extending from the leading end to the trailing end; the first tubular region has an outer diameter which is less than an outer diameter of the second tubular region and the internal passage of the first tubular region has an inner, luminal diameter which is less than an inner diameter of the internal passage of the second tubular region; the first tubular region and the second tubular region have a combined length of from 150 mm to 500 mm, and the first tubular region has a length of from 30 mm to 100 mm; the first tubular region and the second tubular region are formed from one or more materials selected from stainless steel, carbon fibre, hard plastics, ceramic, or glass; and the oocyte retrieval needle is a double lumen needle.
2. The oocyte retrieval needle according to claim 1, wherein the oocyte retrieval needle has a central axis, and the first tubular region and the second tubular region are arranged along the central axis.
3. The oocyte retrieval needle according to claim 1, wherein the sharp point leading end is echogenic.
4. The oocyte retrieval needle according to claim 1, wherein the inner, luminal diameter of the internal passage of the first tubular region is greater than or equal to 0.2 mm and less than the inner diameter of the internal passage of the second tubular region.
5. The oocyte retrieval needle according to claim 1, wherein the inner, luminal diameter of the internal passage of the first tubular region is greater than or equal to 0.4 mm and less than the inner diameter of the internal passage of the second tubular region.
6. The oocyte retrieval needle according to claim 1, wherein the inner, luminal diameter of the internal passage of the first tubular region is greater than or equal to 0.6 mm and less than the inner diameter of the internal passage of the second tubular region.
7. The oocyte retrieval needle according to claim 1, wherein the inner diameter of the internal passage of the second tubular region is 0.9 mm.
8. The oocyte retrieval needle according to claim 1, wherein the inner diameter of the internal passage of the second tubular region is 1.1 mm.
9. The oocyte retrieval needle according to claim 1, wherein the inner diameter of the internal passage of the second tubular region is 1.2 mm.
10. The oocyte retrieval needle according to claim 1, wherein the outer diameter of the first tubular region is from 0.6 mm to 1.2 mm.
11. The oocyte retrieval needle according to claim 10, wherein the outer diameter of the first tubular region is from 0.8 mm to 1.0 mm.
12. The oocyte retrieval needle according to claim 11, wherein the outer diameter of the first tubular region is 0.9 mm.
13. The oocyte retrieval needle according to claim 1, wherein the outer diameter of the second tubular region is 1.1 mm.
14. The oocyte retrieval needle according to claim 1, wherein the outer diameter of the second tubular region is 1.2 mm.
15. The oocyte retrieval needle according to claim 1, wherein the outer diameter of the second tubular region is 1.4 mm.
16. The oocyte retrieval needle according to claim 1, wherein the first tubular region and the second tubular region are connected via a tapered region.
17. The oocyte retrieval needle according to claim 1, wherein the first and second tubular regions have a combined length of from 200 mm to 400 mm.
18. The oocyte retrieval needle according to claim 1, wherein the length of the first tubular region is 40 mm to 60 mm.
19. The oocyte retrieval needle according to claim 1, wherein the first tubular region is formed from one or more stainless steels selected from AISI 304, AISI 316, SIS 2346 and SIS 2543.
20. The oocyte retrieval needle according to claim 1, wherein the second tubular region comprises stainless steel selected from AISI 304, AISI 316, SIS 2346 and SIS 2543.
21. The oocyte retrieval needle according to claim 1, wherein the first tubular region and the second tubular region are formed from a single piece of material.
22. A method of retrieving an oocyte from a subject comprising: inserting an oocyte retrieval needle into a site on the subject from which the oocyte is to be retrieved; and withdrawing the oocyte from the subject by aspiration through the oocyte retrieval needle, wherein the oocyte retrieval needle comprises a first tubular region in fluid communication with a second tubular region, the first tubular region comprising a sharp point leading end configured for insertion into the subject and the second tubular region comprising an open trailing end, the leading end and the trailing end forming respective opposite ends of the needle, wherein: internal passages of the first and second tubular regions form a continuous open passage extending from the leading end to the trailing end; the first tubular region has an outer diameter which is less than an outer diameter of the second tubular region and the internal passage of the first tubular region has an inner, luminal diameter which is less than an inner diameter of the internal passage of the second tubular region; the first tubular region and the second tubular region have a combined length of from 150 mm to 500 mm, and the first tubular region has a length of from 30 mm to 100 mm; the first tubular region and the second tubular region are formed from one or more materials selected from stainless steel, carbon fibre, hard plastics, ceramic, or glass; and the oocyte retrieval needle is a double lumen needle.
23. The method according to claim 22, wherein the first tubular region of the oocyte retrieval needle penetrates a vaginal wall, an ovary, and a follicle of the subject, and the second tubular region of the oocyte retrieval needle does not penetrate the vaginal wall, the ovary, or the follicle of the subject.
24. The method according to claim 22, wherein the subject is a human.
25. The method according to claim 22, further comprising flushing a flushing medium into the oocyte retrieval needle.
26. The method according to claim 25, wherein the flushing medium is flushed into the oocyte retrieval needle through flushing tubing.
27. The method according to claim 22, further comprising collecting the oocyte in a fluid container.
28. The method according to claim 27, wherein the fluid container is separate from the oocyte retrieval needle and is coupled to the open trailing end so as to place an interior of the fluid container in fluid communication with the continuous open passage.
29. The method according to claim 28, wherein the fluid container comprises a test tube, and the open trailing end and the test tube are coupled by aspiration tubing.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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(6) Needles and methods in accordance with the invention will be described, by way of example only, with reference to the further drawings,
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(17) The raw data for
DESCRIPTION OF THE PREFERRED EMBODIMENTS
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(19) Different arrangements of the first tubular region and second tubular region are possible. Some examples are given in
(20) In the sampling needle (732) of
(21) In the sampling needle (832) of
(22) In the sampling needle (932) of
(23) In the sampling needle (1032) of
(24) The sampling needles of
(25) A method of retrieving a sample from a subject, such as retrieval of an oocyte from a subject, comprises insertion of the sampling needle (632) according to
(26) The sampling needles according to
(27) Analysis of Needles According to the Present Invention
(28) Needles according to the invention were analysed in a laboratory setting and in a clinical setting.
(29) Laboratory Analysis
(30) The aspiration time and temperature change of a sample being retrieved using (a) a thin needle, (b) a needle according to the present invention, (c) a standard needle and (d) an adjusted standard needle were analysed. The dimensions of the needles are provided in Table 1.
(31) TABLE-US-00001 TABLE 1 Needle (b) Needle (d) Adjusted (a) Thin according to (c) Standard standard Dimensions needle the invention needle needle First tubular Length (mm) n/a 40 n/a n/a region Outer diameter n/a 0.9 n/a n/a (comprising (mm) leading end) Inner diameter n/a 0.6 n/a n/a (mm) Second Length (mm) n/a 300 n/a n/a tubular region Outer diameter n/a 1.4 n/a n/a (comprising (mm) trailing end) Inner diameter n/a 1.2 n/a n/a (mm) Full length of Length (mm) 350 n/a 355 350 needle Outer diameter 0.8 n/a 1.4 1.4 (mm) Inner diameter 0.6 n/a 1.0 1.2 (mm) n/a: not applicable
(32) The effect of the needle dimensions on the aspiration time of samples of different viscosities was studied. The samples used were water suitable for in vivo injection (water for injection (WFI)), sodium hyaluronate solution (0.2 g.l.sup.1) and sodium hyaluronate (0.4 g.l.sup.1). The sodium hyaluronate solution was prepared by dissolving sodium hyaluronate in WFI.
(33) A vacuum pump (Rocket of London, 240 V, 30 W, 50 Hz) was adjusted to 102 mm Hg (13.6 kPa) and checked with a calibrated pressure meter before each test. A needle was connected to the vacuum pump with 400 mm tubing (ID 1.35 mm) and to a 50 ml test tube, using a 180 cm long piece of PVC tubing, with an ID of 1.35 mm. The test tube (connected to the needle) was placed in a heating block on a table in order to keep a constant distance between the test tube and the floor for all tests. The heating block was adjusted to a desired temperature or turned off. The needle was held vertically throughout the whole test. A timer was started when the needle was inserted into a container holding the sample at room temperature.
(34) For the test of the effect of needle dimension on the aspiration time of WFI, the timer was stopped when 20 ml of the sample had been transferred into the test tube and the test was repeated 5 times for each needle in a randomized sequence. Three needles of each type were used. The temperature of the sample was held at 202 C.
(35) For the test of the effect of needle dimension on the aspiration time of sodium hyaluronate solutions, the timer was stopped when 10 ml of the sample had been transferred into the test tube. The test was repeated 5 times for each needle at randomized sequence. Two needles of each type were used. The temperature of the sample was held at 211 C.
(36) As shown in
(37) TABLE-US-00002 TABLE 2 Mean aspiration times of samples of WFI using needles (a), (b), (c) and (d). The dimensions of needles (a), (b), (c) and (d) are given in Table 1. Raw data are given in Appendix 1. Needle (b) Needle (d) Adjusted (a) Thin according to (c) Standard standard needle the invention needle needle Mean aspiration 189 sec 43 sec 35 sec 24 sec time of 20 ml WFI
(38) Sodium hyaluronate solution is more viscous than WFI. A higher concentration of sodium hyaluronate solution is more viscous than a lower concentration of sodium hyaluronate solution. As shown in
(39) TABLE-US-00003 TABLE 3 Mean aspiration times of samples of sodium hyaluronate (0.2 g l.sup.1) using needles (a), (b), (c) and (d). The dimensions of needles (a), (b), (c) and (d) are given in Table 1. Needle (b) Needle (d) Adjusted (a) Thin according to (c) Standard standard needle the invention needle needle Mean aspiration 267 sec 42 sec 40 sec 26 sec time of 10 ml Na- Hyaluronate 0.2 g l.sup.1
(40) TABLE-US-00004 TABLE 4 Mean aspiration times of samples of sodium hyaluronate (0.4 g l.sup.1) using needles (a), (b), (c) and (d). The dimensions of needles (a), (b), (c) and (d) are given in Table 1. Needle (b) Needle (d) Adjusted (a) Thin according to (c) Standard standard needle the invention needle needle Mean aspiration 635 sec 82 sec 81 sec 50 sec time of 10 ml Na- Hyaluronate 0.4 g l1
(41) In order to test the effect of needle dimension on the temperature of the sample being aspirated, a water bath was heated to a sample retrieval temperature of 370.5 C. and a heating block was heated to a sample delivery temperature of either 250.5 C. or 370.5 C. A 50 ml test tube containing 20 ml water was placed into the heating block in order to standardize the temperature. The temperature was checked with a calibrated thermometer (Vi No 017-69) before each test. The timer was started at the same time as the needle was placed into the water bath with heated water (370.5 C.). When 20 ml of heated water had been aspirated into the test tube, the timer was stopped, the needle was removed from the water and 20 seconds after the needle was removed the temperature of the water inside the test tube was determined. The difference in temperature before and after aspiration was determined.
(42) The test was repeated 5 times for each needle in a randomized sequence. After each test, the needles were flushed with water at room temperature. Four 50 ml FALCON tubes were used as the test tube for the experiment to make sure that each test was started with a tube at room temperature. Two needles of each type were used.
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(44) The data show that samples retrieved with the needle of the invention have faster aspiration times and show a lower reduction in temperature compared with thin needles (OD: 0.8 mm, ID: 0.6 mm. In combination with the lower level of pain associated with needles of small outer diameter, the needle of the invention is beneficial for clinical use. Since oocytes are retrieved, in practice, in a liquid having a higher viscosity than WFI, retrieval of an oocyte using a needle according to the invention is likely to show as short, or almost as short, an aspiration time as retrieval using a standard needle.
(45) The vagina is at body temperature (37 C.). Therefore, use of a sampling needle via the vagina will incubate the sample being retrieved at 37 C. during passage through the vagina and thus reduce temperature loss.
(46) Clinical Analysis
(47) A sampling needle according to the present invention (needle (b) of Table 1) was compared clinically with a standard needle (needle (c) of Table 1). The needles were used to retrieve oocytes from female subjects.
(48) Two IVF clinics in Sweden participated in this clinical trial. For every patient that participated in the evaluation two different kinds of aspiration needles were used. A gynecologist used the needles alternately on different sides of the uterus. A needle according to the present invention (needle (b)) was compared to a standard needle (needle (c)). Because of different appearance of the needles, blinding to the gynecologist was not possible. The study population consisted of a selected number of patients that underwent treatment at the clinics during the study time period. Patients with previous abdominal operations and patients with known endometriosis were excluded. The aspiration process and anesthetic method were done according to clinical standard procedures and were the same for both groups.
(49) To make sure the needle was not affecting the quality of the oocytes, the following data was also collected: number of collected mature oocytes, number of oocytes with normal fertilization (2PN) and early embryo development.
(50) The needles of the invention where reported to be as usable or at least as usable as the standard needle in parameters reflecting easy handling.
(51) Only one of the clinics analyzed the embryo development of the oocytes retrieved with each needle. The results of the analysis are shown in Table 5 and comprise 10 patients with oocytes retrieved according to the protocol described above. The fertilization rate and embryo development up to day 2 for oocytes aspirated with a needle of the invention (needle (b)) was normal compared to the oocytes aspirated with the control needle (needle (c)).
(52) TABLE-US-00005 TABLE 5 Test needle Control (needle (b)) (needle (c)) Fertilization rate 57% 54% Cleaved embryos on day 2 89% 95% >3-cells embryos on day 2 74% 55%
(53) This study suggests that aspiration, i.e. retrieval, of oocytes with the needle according to the invention (needle (b)) has no adverse affect on the success of fertilization or embryo development in comparison to aspiration of oocytes with a standard needle (needle (c)).
(54) Appendix: Raw data for
(55) TABLE-US-00006 TABLE 6 Raw data for FIG. 11; Aspiration time (seconds), water for in vivo injection (WFI). Needle 1 Needle 2 Needle 3 Needle (c): Standard 1.4/1.0 needle Test 1 35 35 34 Test 2 34 35 35 Test 3 35 34 35 Test 4 35 34 34 Test 5 35 35 35 Mean 35 35 35 Total mean 35 Needle (a): Thin 0.8/0.6 needle Test 1 190 188 187 Test 2 190 187 189 Test 3 191 189 187 Test 4 192 190 189 Test 5 193 189 188 Mean 191 189 188 Total mean 189 Needle (b): Needle of the invention Test 1 43 43 42 Test 2 43 43 43 Test 3 44 44 42 Test 4 43 44 42 Test 5 43 43 42 Mean 43 43 42 Total mean 43 Needle (d): Adjusted 1.4/1.2 needle Test 1 24 24 23 Test 2 24 23 24 Test 3 23 23 24 Test 4 23 24 23 Test 5 24 23 24 Mean 24 23 24 Total mean 24 Student's t-test 1.4/1.2 versus Invention P < 0.001 0.8/0.6 versus Invention P < 0.001 1.4/1.0 versus Invention P < 0.001 1.4/1.0 versus 1.4/1.2 P < 0.001 1.4/1.0 versus 0.8/0.6 P < 0.001
(56) TABLE-US-00007 TABLE 7 Raw data for FIG. 12; Aspiration time (seconds), sodium hyaluronate [0.2 g/l]. Needle 1 Needle 2 Needle (c): Standard 1.4/1.0 needle Test 1 40 41 Test 2 40 40 Test 3 40 39 Test 4 40 39 Test 5 41 39 Mean 40 40 Total mean 40 Needle (a): Thin 0.8/0.6 needle Test 1 268 267 Test 2 267 260 Test 3 269 264 Test 4 270 265 Test 5 269 269 Mean 269 265 Total mean 267 Needle (b): Needle of the invention Test 1 43 42 Test 2 43 41 Test 3 43 41 Test 4 42 41 Test 5 42 41 Mean 43 41 Total mean 42 Needle (d): Adjusted 1.4/1.2 needle Test 1 27 25 Test 2 27 25 Test 3 26 25 Test 4 26 25 Test 5 26 25 Mean 26 25 Total mean 26 Student's t-test 1.4/1.2 versus Invention P < 0.001 0.8/0.6 versus Invention P < 0.001 1.4/1.0 versus Invention P < 0.001 1.4/1.0 versus 1.4/1.2 P < 0.001 1.4/1.0 versus 0.8/0.6 P < 0.001
(57) TABLE-US-00008 TABLE 8 Raw data for FIG. 13; Aspiration time (seconds), sodium hyaluronate [0.4 g/l]. Needle 1 Needle 2 Needle (c): Standard 1.4/1.0 needle Test 1 80 82 Test 2 79 81 Test 3 80 81 Test 4 80 82 Test 5 81 81 Mean 80 81 Total mean 81 Needle (a): Thin 0.8/0.6 needle Test 1 647 636 Test 2 655 622 Test 3 660 621 Test 4 639 617 Test 5 637 618 Mean 648 623 Total mean 635 Needle (b): Needle of the invention Test 1 80 82 Test 2 79 83 Test 3 80 84 Test 4 81 83 Test 5 80 83 Mean 80 83 Total mean 82 Needle (d): Adjusted 1.4/1.2 needle Test 1 50 49 Test 2 50 50 Test 3 50 49 Test 4 50 50 Test 5 50 50 Mean 50 50 Total mean 50 Student's t-test 1.4/1.2 versus Invention P < 0.001 0.8/0.6 versus Invention P < 0.001 1.4/1.0 versus Invention P = 0.213 1.4/1.0 versus 1.4/1.2 P < 0.001 1.4/1.0 versus 0.8/0.6 P < 0.001
(58) TABLE-US-00009 TABLE 9 Raw data for FIG. 14; Aspiration temperature change test, 20 ml WFI at 37 C. to 25 C. Needle 1 Needle 2 Needle (c): Standard 1.4/1.0 needle Test 1 2.6 2.6 Test 2 2.4 2.8 Test 3 2.6 2.7 Test 4 2.5 2.7 Test 5 2.5 2.6 Mean 2.5 2.7 Total mean 2.6 Needle (a): Thin 0.8/0.6 needle Test 1 4.3 3.9 Test 2 4.1 4.1 Test 3 4.2 4.0 Test 4 4.0 3.9 Test 5 4.1 4.0 Mean 4.1 4.0 Total mean 4.1 Needle (b): Needle of the invention Test 1 2.7 2.6 Test 2 2.8 2.5 Test 3 2.7 2.5 Test 4 2.7 2.6 Test 5 2.7 2.6 Mean 2.7 2.6 Total mean 2.6 Needle (d): Adjusted 1.4/1.2 needle Test 1 1.4 1.5 Test 2 1.8 1.5 Test 3 1.5 1.4 Test 4 1.9 1.3 Test 5 1.4 1.3 Mean 1.6 1.4 Total mean 1.5 Student's t-test 1.4/1.2 versus Invention P < 0.001 0.8/0.6 versus Invention P < 0.001 1.4/1.0 versus Invention P = 0.412 1.4/1.0 versus 1.4/1.2 P < 0.001 1.4/1.0 versus 0.8/0.6 P < 0.001
(59) TABLE-US-00010 TABLE 10 Raw data for FIG. 15; Aspiration temperature change test, 20 ml WFI at 37 C. to 37 C. Needle 1 Needle 2 Needle (c): Standard 1.4/1.0 needle Test 1 1.5 1.6 Test 2 1.6 1.5 Test 3 1.5 1.5 Test 4 1.4 1.3 Test 5 1.3 1.3 Mean 1.5 1.4 Total mean 1.5 Needle (a): Thin 0.8/0.6 needle Test 1 2.5 2.9 Test 2 2.6 2.6 Test 3 2.3 2.6 Test 4 2.7 2.6 Test 5 2.5 2.6 Mean 2.5 2.7 Total mean 2.6 Needle (b): Needle of the invention Test 1 1.4 1.7 Test 2 1.3 1.4 Test 3 1.3 1.4 Test 4 1.3 1.4 Test 5 1.3 1.4 Mean 1.3 1.5 Total mean 1.4 Needle (d): Adjusted 1.4/1.2 needle Test 1 1.2 0.9 Test 2 1.2 0.8 Test 3 1.2 0.8 Test 4 1.2 0.9 Test 5 1.2 0.8 Mean 1.2 0.8 Total mean 1.0 Student's t-test 1.4/1.2 versus Invention P < 0.001 0.8/0.6 versus Invention P < 0.001 1.4/1.0 versus Invention P = 0.274 1.4/1.0 versus 1.4/1.2 P < 0.001 1.4/1.0 versus 0.8/0.6 P < 0.001
(60) TABLE-US-00011 TABLE 11 Comparison of the effect of needle dimensions on fertilization and embryo development of oocytes harvested using a control needle (needle (c): outer diameter 1.4 mm, inner diameter 1.0 mm) and a test needle according to the invention (needle (b)). Fertilization Needle # (test or Method of #mature fertilized Development Day 2 control = fertilization # oocytes oocytes # Treatment single (ICSI or collected (MII) (in case (Sum of 1, cleaved # 2-cell # 3-cell # 4-cell # >4-cell No. lumen) IVF) oocytes of ICSI) 2 and 3 PN) #2 PN embryos embryos embryos embryos embryos 1b c IVF 2 2 1 1 1 2a c IVF 4 3 2 2 1 1 3b c IVF 3 3 3 3 1 2 4a c IVF 1 1 1 1 1 5a c IVF 7 4 4 4 4 6b c IVF 3 2 2 1 1 7a c ICSI (TESA) 3 2 1 1 1 1 8a c ICSI 6 3 2 2 2 2 9b c IVF 11 5 5 5 4 1 10a c ICSI (TESA) 6 5 1 1 1 1 46 41 22 21 8 1 11 1 1a t IVF 1 1 1 1 1 2b t IVF 6 5 5 5 1 3 1 3a t IVF 3 2 2 2 2 4b t IVF 3 3 3 3 2 1 5b t IVF 4 3 3 3 2 1 6a t IVF 5 2 2 1 1 7b t ICSI (TESA) 3 3 0 0 0 8b t ICSI 8 6 4 4 4 3 1 9a t IVF 10 6 6 4 4 10b t ICSI (TESA) 7 6 1 1 1 1 50 47 27 24 4 0 17