Reproductive Services, Melbourne IVF and Royal Women's Hospital, Parkville, VIC, Australia.
Hum Reprod. 2013 Nov;28(11):2996-9. doi: 10.1093/humrep/det360. Epub 2013 Sep 7.
Ovarian tissue cryopreservation and transplantation is a form of fertility preservation offered to young women at high risk of losing ovarian function after cancer treatment. While there have been successful births resulting from orthotopic site grafts, we report the first case of an ongoing pregnancy from a heterotopic graft in a patient who had previously undergone bilateral oopherectomy for a granulosa cell tumour. Frozen-thawed ovarian tissue was transplanted to the anterior abdominal wall. Subsequent ovarian stimulation and transabdominal ultrasound-guided oocyte retrieval from the grafts resulted in two oocytes. These were fertilized with ICSI and two embryos were transferred. Serial ultrasounds have confirmed an ongoing 26-week intrauterine twin pregnancy. Thus, this first demonstration of a pregnancy from a heterotopic graft site provides unequivocal evidence that cryopreservation preserves complete follicle development and that normal ovarian function can occur at a non-ovarian site. This provides optimism for further efforts to assist women who have had oophorectomy and pelvic surgery or radiotherapy, without an appropriate orthotopic site for grafting.
卵巢组织冻存与移植是一种生育力保存方式，适用于那些在癌症治疗后极有可能丧失卵巢功能的年轻女性。虽然已有研究报道在卵巢原位移植后成功妊娠的案例，但我们首次报告了一例患者在接受双侧卵巢切除术治疗颗粒细胞瘤后，通过异位移植实现妊娠的案例。将冻融的卵巢组织移植到患者的前腹壁，随后进行卵巢刺激，并经腹超声引导从移植物中获取卵母细胞，共获得 2 枚卵母细胞。通过 ICSI 受精后，移植了 2 枚胚胎。连续超声检查证实了目前妊娠 26 周的宫内双胞胎。因此，首例异位移植妊娠的成功证明了冻存可以完整保存卵泡发育，并且正常的卵巢功能可以在非卵巢部位发生。这为进一步努力提供了希望，以帮助那些已经接受了卵巢切除术、盆腔手术或放疗但没有合适的卵巢原位移植部位的女性。
