Personalized medicine in the evaluation of Müllerian anomalies: the role of three-dimensional printing technology

Jessica Garcia de Paredes; Jordan Gosnell; Mili Thakur; Marcos Cordoba

doi:10.1016/j.xfre.2024.05.003

Personalized medicine in the evaluation of Müllerian anomalies: the role of three-dimensional printing technology

F S Rep. 2024 May 16;5(3):279-284. doi: 10.1016/j.xfre.2024.05.003. eCollection 2024 Sep.

Authors

Jessica Garcia de Paredes^{1

2}, Jordan Gosnell^{3

4}, Mili Thakur^{1

2

5}, Marcos Cordoba^{1

2

6}

Affiliations

¹ Department of Obstetrics, Gynecology and Women's Health, Corewell Health, Grand Rapids, Michigan.
² Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, Michigan.
³ Betz Advanced Visualization and Innovation Center, Corewell Health Helen DeVos Children's Hospital, Grand Rapids, Michigan.
⁴ Betz Congenital Heart Center, Corewell Health Helen DeVos Children's Hospital, Grand Rapids, Michigan.
⁵ Reproductive Genomics Program, The Fertility Center, Grand Rapids, Michigan.
⁶ Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Women's Health, Corewell Health Medical Group, Grand Rapids, Michigan.

Abstract

Objective: To present the comprehensive methodology for generating personalized three-dimensional (3D) printed uterine models from 3D ultrasound (US) volumes in individuals diagnosed with Müllerian anomalies and discuss potential applications in the field of reproductive endocrinology and infertility.

Design: Pilot study.

Setting: Single large university-affiliated teaching hospital.

Patients: Patients with the presence of a Müllerian anomaly between the ages of 18 and 45 years attending the maternal-fetal medicine as well as reproductive endocrinology and infertility outpatient offices from 2018 to 2023 were included in the study.

Interventions: Subjects underwent 3D US transvaginal scanning for the collection of data. The 3D US volumes were acquired, edited, and exported from a US cart Voluson E10 system (GE Healthcare, Chicago, IL). High-definition virtual models were created and modified, making them suitable for printing using Materialise 3-Matic Medical (Materialise NV, Leuven, Belgium). The models were printed on a J5 MediJet 3D printer (Stratasys, Rehovot, Israel). Colors were set to mimic a realistic appearance, and shore values were set before printing.

Main outcome measures: Successful creation and utilization of personalized 3D-printed uterine models for individuals with Müllerian anomalies.

Resultss: Three-dimensional models were created for a uterus without anomalies, 2 variations of a partial septum, a unicornuate, and a didelphys uterus. Models were used as a tactile and customized tool for patient education, counseling, and medical student and resident teaching. This technique illustrates that the creation of personalized 3D-printed uterine models for utilization in the fields of reproductive endocrinology and infertility is feasible.

Conclusions: We propose a novel use of individualized 3D-printed uterine models in the evaluation of individuals with Müllerian anomalies. These models may play a complementary role to standard imaging options in the assessment of these anomalies, with a special potential for application in highly complex or yet-to-be-determined types of anomalies.

Keywords: 3D printing; 3D ultrasound; Müllerian anomalies; innovation.