Meirow Dror, Levron Jacob, Eldar-Geva Talia, Hardan Izhar, Fridman Eduard, Yemini Ziva, Dor Jehoshua
IVF Unit, Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Fertil Steril. 2007 Feb;87(2):418.e7-418.e15. doi: 10.1016/j.fertnstert.2006.05.086. Epub 2006 Nov 13.
To investigate fertility potential of ovarian tissue harvested after chemotherapy, to monitor ovarian recovery after transplantation, and to compare with in vitro fertilization (IVF) cycles.
Clinical and endocrine study.
IVF unit and hematology department in a tertiary university hospital.
PATIENT(S): A 28-year-old patient suffering from non-Hodgkin's lymphoma had some of her ovarian tissue cryopreserved shortly after conventional chemotherapy and failure to respond to ovarian stimulation but before sterilizing treatment.
INTERVENTION(S): Transplantation of cryopreserved ovarian tissue; four IVF cycles.
MAIN OUTCOME MEASURE(S): Gonadotropins, ovarian steroids, anti-Mullerian hormone (AMH), inhibin B, ovarian histology, sonography, and outcome of IVF cycles.
RESULT(S): Large number of primordial follicles were present in the harvested tissue. During the first months after transplantation, gonadotropins were high, AMH and inhibin B were low, and in three IVF cycles, eggs were not found. After recovery of endocrine activity 9 months after transplantation, a mature oocyte was retrieved. Embryo transfer resulted in a normal pregnancy and delivery of a healthy baby. Although spontaneous menstruation resumed after delivery, endocrine profile 22 months after transplantation indicated low reserve.
CONCLUSION(S): The recovery of endocrine function after transplantation correlated with the result of oocyte recovery. Fertility preservation using ovarian tissue is effective also in cases when the ovaries are injured after chemotherapy. However, transplant life span is limited.
研究化疗后采集的卵巢组织的生育潜力，监测移植后的卵巢恢复情况，并与体外受精（IVF）周期进行比较。
临床和内分泌研究。
一所三级大学医院的体外受精科和血液科。
一名28岁的非霍奇金淋巴瘤患者在接受传统化疗且对卵巢刺激无反应后，但在绝育治疗前，将其部分卵巢组织进行了冷冻保存。
移植冷冻保存的卵巢组织；四个体外受精周期。
促性腺激素、卵巢甾体激素、抗苗勒管激素（AMH）、抑制素B、卵巢组织学、超声检查以及体外受精周期的结果。
采集的组织中存在大量原始卵泡。移植后的最初几个月，促性腺激素水平较高，AMH和抑制素B水平较低，在三个体外受精周期中未发现卵子。移植9个月后内分泌活动恢复，采集到一枚成熟卵母细胞。胚胎移植后成功妊娠并分娩出一名健康婴儿。尽管产后自发月经恢复，但移植22个月后的内分泌状况显示卵巢储备功能低下。
移植后的内分泌功能恢复与卵母细胞采集结果相关。在化疗后卵巢受损的情况下，采用卵巢组织进行生育力保存也是有效的。然而，移植后的存活时间有限。
