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利用储存的卵巢组织对癌症患者进行生育力保存:临床方面

Fertility preservation in cancer patients using stored ovarian tissue: clinical aspects.

作者信息

Meirow Dror

机构信息

IVF Unit, Division of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel.

出版信息

Curr Opin Endocrinol Diabetes Obes. 2008 Dec;15(6):536-47. doi: 10.1097/MED.0b013e32831a44a8.

Abstract

PURPOSE OF REVIEW

This review covers the medical approach and laboratory guidelines needed for fertility preservation using stored ovarian tissue in cancer patients. Indications, careful patient selection and timing are essential. Techniques for tissue harvesting and storage are evaluated. Up-to-date information on publications reporting on transplantation, recovery of endocrine function, pregnancy and delivery of healthy babies is reviewed as well as relevant data on safety measures to detect cancer cells in stored ovarian tissue.

RECENT FINDINGS

Recent literature review indicates 12 pregnancies, five deliveries of healthy babies and two ongoing pregnancies after transplantation of ovarian tissue using different methods. To increase the safety of ovarian tissue cryopreservation-reimplantation procedures, algorithm and methods to identify tumor involvement in the ovaries and detection of small numbers of cancer cells in ovarian tissue were recently reported.

SUMMARY

Cryopreservation of ovarian tissue has been practiced for over a decade in an attempt to preserve fertility before the commencement of potentially sterilizing chemotherapy. With more than a few recent reports on pregnancies and deliveries after transplantation of ovarian tissue, there will be more patients requesting the storage of ovarian tissue in order to preserve fertility prior to cancer treatments.

摘要

综述目的

本综述涵盖了癌症患者使用储存的卵巢组织进行生育力保存所需的医学方法和实验室指南。适应症、谨慎的患者选择和时机选择至关重要。对组织采集和储存技术进行了评估。回顾了有关移植、内分泌功能恢复、妊娠及健康婴儿分娩的最新出版物信息,以及检测储存卵巢组织中癌细胞的安全措施的相关数据。

最新发现

近期文献综述表明,采用不同方法移植卵巢组织后有12例妊娠、5例健康婴儿分娩及2例妊娠仍在继续。为提高卵巢组织冷冻保存-再植入程序的安全性,最近报道了识别卵巢肿瘤累及情况及检测卵巢组织中少量癌细胞的算法和方法。

总结

卵巢组织冷冻保存已实施了十多年,旨在在可能导致绝育的化疗开始前保存生育力。随着近期有关卵巢组织移植后妊娠和分娩的报道增多,将会有更多患者要求储存卵巢组织以在癌症治疗前保存生育力。

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