Frauenklinik des Universitätsklinikums Erlangen, Universitätsstrasse 21-23, Erlangen, Germany.
Dtsch Arztebl Int. 2008 Apr;105(15):274-8. doi: 10.3238/arztebl.2008.0274. Epub 2008 Apr 11.
New anticancer treatments have increased survival rates for cancer patients but often at the cost of sterility. One way of preserving fertility in these patients is the use of cryopreservation of ovarian tissue with subsequent retransplantation following a period of recurrence-free survival. We report the follow-up of the first case of retransplantation of ovarian tissue in Germany.
Immediately following the diagnosis of anal cancer, ovarian tissue was removed laparoscopically, and cryopreserved. The patient was then treated with combined radiochemotherapy, which resulted in iatrogenic premature ovarian failure, and was associated with inhibin B serum levels lower than 10 ng/L. After the 2.5 year period of cancer remission, the cryopreserved ovarian tissue was retransplanted orthotopically.
Five months later estradiol serum levels had risen from lower than 20 pg/mL to 436 pg/mL. Three ovarian follicles were detected ultrasonographically in the pelvic side wall. Finally the patient reported her first menstruation after the intervention. The endocrine activity of the transplanted cryopreserved tissue has demonstrated viability, and the ability to develop.
Cycle monitoring and timed intercourse should now help to achieve conception. These first results from Germany for retransplantation of cryopreserved ovarian tissue clearly show its potential for preserving fertility.
新的抗癌治疗方法提高了癌症患者的生存率，但往往是以不育为代价的。在这些患者中，保留生育能力的一种方法是使用卵巢组织冷冻保存，然后在无复发生存期后进行再移植。我们报告了德国首例卵巢组织再移植的随访结果。
在诊断出肛门癌后，立即通过腹腔镜取出卵巢组织并进行冷冻保存。然后，患者接受了联合放化疗，导致医源性卵巢早衰，抑制素 B 血清水平低于 10ng/L。在癌症缓解 2.5 年后，冷冻保存的卵巢组织被原位再移植。
五个月后，雌二醇血清水平从低于 20pg/mL 上升到 436pg/mL。在骨盆侧壁超声检测到 3 个卵巢卵泡。最后，患者报告说她在干预后第一次来月经。移植的冷冻保存组织的内分泌活性显示出了活力和发育能力。
现在应该通过周期监测和定时性交来帮助实现受孕。德国首例冷冻保存卵巢组织再移植的结果清楚地显示了其保留生育能力的潜力。
