Department of Gynecology, Université Catholique de Louvain, Cliniques Universitaires St Luc, Avenue Hippocrate 10, Brussels 1200, Belgium.
Hum Reprod Update. 2010 Nov-Dec;16(6):617-30. doi: 10.1093/humupd/dmq010. Epub 2010 May 12.
In prepubertal and adolescent girls, fertility may be impaired by gonadotoxic treatments, repeat ovarian surgery or genetic disorders. Cryopreservation of ovarian cortex is an existing option to preserve fertility in these young girls at risk of premature ovarian failure (POF). The efficacy, feasibility and risks of ovarian cryopreservation in children must be assessed in order to validate the technique.
Here, we conducted a review of ovarian cryopreservation in adults and, more specifically, in children using the PubMed databases. In addition, our own experience with ovarian cryopreservation in children was evaluated and compared with the literature.
Analysis of the literature and six published series on ovarian cryopreservation in children, as well as our own series of 58 cases, show that there is no reason to doubt its efficacy in this young population. However, no consensus has yet been reached on the indications for the technique. Indeed, with existing models, the real risk of POF may be over- or underestimated.
Our review suggests that ovarian cortex cryopreservation is feasible and as safe as comparable operative procedures in children. Although no births have yet resulted from freeze-thawing of prepubertal ovarian cortex, the results of this approach in adults are encouraging. However, the absence of consensus on the indications for fertility preservation, as well as the optimal timing and quantity of ovarian cortex for cryopreservation, should be taken into consideration when discussing fertility issues with girls at risk of POF and their parents.
在青春期前和青春期的女孩中，性腺毒性治疗、反复卵巢手术或遗传疾病可能会损害生育能力。冷冻保存卵巢皮质是一种现有的选择，可以在有发生卵巢早衰（POF）风险的年轻女孩中保留生育能力。为了验证该技术，必须评估儿童卵巢冷冻保存的疗效、可行性和风险。
我们使用 PubMed 数据库对成人，特别是儿童的卵巢冷冻保存进行了综述。此外，我们还评估和比较了自己在儿童中进行卵巢冷冻保存的经验和文献。
对文献和六篇关于儿童卵巢冷冻保存的已发表系列文章的分析，以及我们自己的 58 例系列文章，表明在这个年轻人群中，没有理由怀疑其疗效。然而，对于该技术的适应证，尚未达成共识。实际上，根据现有模型，POF 的真正风险可能被高估或低估。
我们的综述表明，卵巢皮质冷冻保存在儿童中是可行的，与类似的手术操作一样安全。虽然从冷冻解冻的青春期前卵巢皮质中还没有产生婴儿，但该方法在成人中的结果令人鼓舞。然而，在与有发生 POF 风险的女孩及其父母讨论生育问题时，应考虑到对生育保护的适应证缺乏共识，以及卵巢皮质冷冻保存的最佳时机和数量。
