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生育力保存:冷冻保存的卵巢组织在一名曾接受霍奇金病治疗的年轻患者中的成功移植。

Fertility preservation: successful transplantation of cryopreserved ovarian tissue in a young patient previously treated for Hodgkin's disease.

作者信息

Demeestere Isabelle, Simon Philippe, Emiliani Serena, Delbaere Anne, Englert Yvon

机构信息

Research Laboratory on Human Reproduction, Campus Erasme (Bat GE) CP636, 808 Route de Lennik, 1070, Brussels, Belgium.

出版信息

Oncologist. 2007 Dec;12(12):1437-42. doi: 10.1634/theoncologist.12-12-1437.

Abstract

Cryopreservation of ovarian tissue is now offered as an experimental procedure to preserve the fertility of young patients with a high risk for premature ovarian failure resulting from cancer therapy. This is the only available option to preserve the fertility of prepubertal patients treated with gonadotoxic chemotherapy. At present, thousands of patients all over the world have undergone this procedure with the hope of later restoring their fertility. Although the efficiency of the transplantation of cryopreserved ovarian tissue to restore ovarian function has been established, reports of pregnancy are still very scarce. Here, we describe the second published full-term spontaneous pregnancy after an orthotopic and heterotopic transplantation of cryopreserved ovarian tissue in a 31-year-old woman previously treated by conditioning therapy for bone marrow transplantation for Hodgkin's disease. This birth gives compelling evidence for the graft origin of the gamete and confirms the efficacy of ovarian tissue transplantation in restoring human natural fertility after oncological treatment. This case report stresses the importance of proposing the ovarian tissue cryopreservation procedure to all young patients who require potentially sterilizing treatment, with all alternative options to preserve fertility being duly taken into consideration.

摘要

卵巢组织冷冻保存目前作为一种实验性方法,用于保护因癌症治疗而有高卵巢早衰风险的年轻患者的生育能力。这是保护接受性腺毒性化疗的青春期前患者生育能力的唯一可用选择。目前,世界各地成千上万的患者接受了这一手术,希望日后恢复生育能力。尽管冷冻保存的卵巢组织移植恢复卵巢功能的效率已得到证实,但妊娠报道仍然非常稀少。在此,我们描述了一名31岁女性在接受霍奇金病骨髓移植预处理治疗后,冷冻保存的卵巢组织原位和异位移植后第二次公开报道的足月自然妊娠。此次分娩有力地证明了配子的移植物来源,并证实了卵巢组织移植在肿瘤治疗后恢复人类自然生育能力方面的有效性。本病例报告强调了向所有需要可能导致绝育治疗的年轻患者推荐卵巢组织冷冻保存手术的重要性,同时应充分考虑所有其他保护生育能力的选择。

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