Huser M, Crha I, Hudecek R, Ventruba P, Zakova J, Smardova L, Kral Z
Department of Obstetrics and Gynecology, Brno University Hospital and Masaryk University School of Medicine, Brno, Czech Republic.
Eur J Gynaecol Oncol. 2007;28(4):249-55.
Malignant disease and the therapy are major factors that may result in complete loss of fertility. There are several strategies for fertility preservation in fertile women faced with cancer. A modern and potentially effective method of reproductive function protection is ovarian tissue cryopreservation.
This paper summarizes the medical and scientific knowledge in this interesting multidisciplinary medical field. Furthermore, the authors' own experience with this novel and interesting method of ovarian tissue protection is presented. Ovarian tissue was obtained during laparoscopic surgery in five nuliparous women (aged 19-33) with a diagnosis of lymphoma before chemotherapy from 2004 to 2006. After laboratory preparation, tissue was frozen by a slow cooling technique and stored in liquid nitrogen.
In total 75 women with malignant lymphoma before chemotherapy were referred to our center for consultation--68 chose ovarian inactivation by GnRH analogues during chemotherapy, two IVF cycles with embryo or oocyte cryopreservation and five ovarian tissue cryopreservation. In these five women one to two slices of ovarian cortex from both ovaries were recovered. Totally 20 cryotubes with three pieces of tissue in each were cryopreserved. In no case was metastasis of cancer cells found by histological evaluation.
Cryopreservation of ovarian tissue represents an effective alternative or addition to the cryopreservation of embryos or oocytes for women at risk of premature ovarian failure due to chemotherapy. Reproductive function protection requires close cooperation between oncology departments and assisted reproduction centers.
恶性疾病及其治疗是可能导致生育能力完全丧失的主要因素。对于面临癌症的育龄妇女，有多种生育力保存策略。一种现代且可能有效的生殖功能保护方法是卵巢组织冷冻保存。
本文总结了这个有趣的多学科医学领域的医学和科学知识。此外，还介绍了作者在这种新颖且有趣的卵巢组织保护方法方面的自身经验。2004年至2006年期间，在5名未生育的淋巴瘤女性患者（年龄19 - 33岁）化疗前的腹腔镜手术中获取卵巢组织。经实验室处理后，采用慢速冷却技术将组织冷冻并储存于液氮中。
共有75名化疗前的恶性淋巴瘤女性患者转诊至我们中心咨询——68名患者选择在化疗期间使用促性腺激素释放激素类似物使卵巢失活，2名患者进行了两个体外受精周期并冷冻保存胚胎或卵母细胞，5名患者进行了卵巢组织冷冻保存。在这5名女性患者中，从双侧卵巢获取了一到两片卵巢皮质。共冷冻保存了20个冻存管，每个冻存管中有3块组织。经组织学评估，未发现癌细胞转移的情况。
对于因化疗有卵巢早衰风险的女性，卵巢组织冷冻保存是胚胎或卵母细胞冷冻保存的一种有效替代方法或补充方法。生殖功能保护需要肿瘤科室与辅助生殖中心密切合作。
