Callejo J, Salvador C, Miralles A, Vilaseca S, Lailla J M, Balasch J
Department of Obstetrics and Gynecology, Hospital Universitari Sant Joan de Déu, Barcelona, Spain.
J Clin Endocrinol Metab. 2001 Sep;86(9):4489-94. doi: 10.1210/jcem.86.9.7871.
The transplantation of ovarian tissue has recently been the focus of intense investigation with the aim of avoiding premature ovarian failure mainly in patients receiving chemotherapy or radiotherapy for malignant disease. Here, we present an evaluation of the long-term function of both fresh (patients 1, 2, and 3) and cryopreserved (patient 4) ovarian autografts in four premenopausal patients aged 46-49 yr who underwent heterotopic ovarian transplantation and were followed over a 1-yr period without receiving gonadotropins to stimulate follicular growth. In patients 1 and 2, approximately 1 cm(3) ovarian cortical autograft was placed sc in the inner aspect of the arm, whereas and in patients 3 and 4 minced ovarian tissue was placed into a muscle pocket in the abdominal wall. In patients 1, 2, and 4 the ovarian hormone secretion (as suggested by sequential estradiol and FSH serum measurements) was reestablished 3-4 months after autotransplantation, and graft function was not improved by immediate rather than delayed heterotopic ovarian autografting. Despite a reestablished ovarian function, a 2- to 7-fold increase in peripheral FSH concentration was evidenced. The cases reported here suggest that hormonal protection can be restored after fresh or cryopreserved heterotopic ovarian transplantation in women, albeit for only a short reproductive span.
卵巢组织移植近来一直是深入研究的焦点，其目的主要是避免接受恶性疾病化疗或放疗的患者出现卵巢早衰。在此，我们对4名年龄在46 - 49岁的绝经前患者的新鲜（患者1、2和3）和冷冻保存（患者4）卵巢自体移植的长期功能进行了评估，这些患者接受了异位卵巢移植，并在未接受促性腺激素刺激卵泡生长的情况下随访了1年。在患者1和2中，约1 cm³的卵巢皮质自体移植物被皮下置于手臂内侧，而在患者3和4中，切碎的卵巢组织被放入腹壁的肌肉袋中。在患者1、2和4中，自体移植后3 - 4个月卵巢激素分泌得以重建（通过连续测定血清雌二醇和促卵泡激素表明），并且即刻而非延迟的异位卵巢自体移植并未改善移植物功能。尽管卵巢功能得以重建，但外周促卵泡激素浓度升高了2至7倍。此处报告的病例表明，女性新鲜或冷冻保存的异位卵巢移植后可以恢复激素保护，尽管生殖期较短。
