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冷冻/解冻卵巢组织自体移植后成功妊娠两例。

Two successful pregnancies following autotransplantation of frozen/thawed ovarian tissue.

作者信息

Andersen Claus Yding, Rosendahl Mikkel, Byskov Anne Grete, Loft Anne, Ottosen Christian, Dueholm Margit, Schmidt Kirsten L T, Andersen Anders Nyboe, Ernst Erik

机构信息

Laboratory of Reproductive Biology, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark.

出版信息

Hum Reprod. 2008 Oct;23(10):2266-72. doi: 10.1093/humrep/den244. Epub 2008 Jul 3.

Abstract

BACKGROUND

Cryopreservation of the ovarian cortex with subsequent autotransplantation has, on an experimental basis, been performed to preserve fertility in women being treated for a malignant disease. The present study reports ovarian activity and pregnancies following autotransplantation of frozen/thawed ovarian tissue.

METHODS

One complete ovary was cryopreserved from each of six patients who were 26-35 years old prior to treatment. Tissue from three of the patients was transported 4-5 h on ice prior to cryopreservation. After a period of 17-32 months, orthotopic autotransplantation was performed replacing 20-60% of the tissue. Two patients received additional heterotopic transplants.

RESULTS

In all cases, the tissue restored menstrual cyclicity 14-20 weeks following transplantation. Four of the six women conceived following assisted reproduction: two women (who had the tissue transported 4-5 h prior to cryopreservation) each, based on the orthotopic transplanted tissue, delivered one healthy child (February 2007 and January 2008); one woman miscarriaged in gestational Week 7; and the other had a positive hCG test but no clinical pregnancy. The remaining two women did not become pregnant.

CONCLUSIONS

Two additional healthy children have been born as a result of the ovarian cryopreservation procedure. In both cases, the ovarian tissue was transported 4-5 h prior to freezing demonstrating that hospitals may offer cryopreservation without having the necessary expertise locally.

摘要

背景

在实验基础上,已开展卵巢皮质冷冻保存及后续自体移植,以保留罹患恶性疾病女性的生育能力。本研究报告了冻融卵巢组织自体移植后的卵巢活性及妊娠情况。

方法

从6例治疗前年龄在26至35岁的患者中各取一个完整卵巢进行冷冻保存。其中3例患者的组织在冷冻保存前于冰上运输4至5小时。17至32个月后,进行原位自体移植,移植组织占比20%至60%。2例患者还接受了异位移植。

结果

所有病例中,组织在移植后14至20周恢复月经周期。6名女性中有4名在辅助生殖后受孕:2名女性(其组织在冷冻保存前于冰上运输4至5小时)各自基于原位移植组织产下一名健康婴儿(2007年2月和2008年1月);1名女性在妊娠第7周流产;另1名女性hCG检测呈阳性但未临床妊娠。其余2名女性未受孕。

结论

卵巢冷冻保存手术又诞育了2名健康婴儿。在这两例中,卵巢组织在冷冻前于冰上运输4至5小时,这表明医院在当地缺乏必要专业知识的情况下也可提供冷冻保存服务。

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