Research Laboratory on Human Reproduction, Medicine Faculty, Université Libre de Bruxelles (ULB), Erasme Hospital, 808 Route de Lennik, 1070 Brussels, Belgium.
Hum Reprod Update. 2009 Nov-Dec;15(6):649-65. doi: 10.1093/humupd/dmp021. Epub 2009 May 27.
Transplantation of ovarian tissue is, at present, the only clinical option available to restore fertility using cryopreserved ovarian tissue. More than 30 transplantations of cryopreserved tissue have been reported, and six babies have been born, worldwide, following this procedure. Despite these encouraging results, it is essential to optimize the procedure by improving the follicular survival, confirming safety and developing alternatives. Here, we review the different factors affecting follicular survival and growth after grafting.
Relevant studies were identified by searching Pubmed up to January 2009 with English language limitation. The following key words were used: (ovarian tissue or whole ovary) AND (transplantation) AND (cryopreservation or pregnancy). Using the literature and personal experience, we examined relevant data on the different exogenous and clinical factors affecting follicular development after grafting.
Clinical factors such as the patient's age and the transplantation sites influenced the lifespan of the graft. A heterotopic transplantation site is not optimal but offers some advantages and it may also promote the hormonal environment after a combined heterotopic and orthotopic transplantation. Exogenous factors such as antioxidants, growth factors or hormones were tested to improve follicular survival; however, their efficiency regarding further follicular development and fertility potential remains to be established.
Additional evidence is required to define optimal conditions for ovarian tissue transplantation. Alternatives such as whole ovary or isolated follicles transplantations require further investigation but are likely to be successful in humans in the future.
目前，使用冷冻卵巢组织进行移植是恢复生育能力的唯一临床选择。在全球范围内，已经报道了超过 30 例冷冻组织移植，并且已经有 6 名婴儿通过该程序出生。尽管这些结果令人鼓舞，但必须通过提高卵泡存活率、确认安全性和开发替代方法来优化该程序。在这里，我们回顾了影响移植后卵泡存活和生长的不同因素。
使用英语语言限制，通过搜索 Pubmed 数据库，我们在 2009 年 1 月之前确定了相关研究。使用的关键词如下：（卵巢组织或整个卵巢）和（移植）和（冷冻保存或妊娠）。利用文献和个人经验，我们检查了与影响移植后卵泡发育的不同外源性和临床因素相关的相关数据。
临床因素，如患者的年龄和移植部位，影响移植物的寿命。异位移植部位并不理想，但具有一些优势，并且在进行异位和原位联合移植后，也可能促进激素环境。已经测试了抗氧化剂、生长因子或激素等外源性因素以提高卵泡存活率；然而，它们对进一步的卵泡发育和生育潜力的效率仍有待确定。
需要更多的证据来定义卵巢组织移植的最佳条件。全卵巢或分离的卵泡移植等替代方法需要进一步研究，但在未来可能会在人类中取得成功。
