Centre for Reproductive Medicine, UZ Brussel, Brussels, Belgium.
IVI Valencia, Valencia, Spain.
Lancet. 2014 Oct 4;384(9950):1311-9. doi: 10.1016/S0140-6736(14)61261-7.
Cryopreservation of eggs or ovarian tissue to preserve fertility for patients with cancer has been studied since 1994 with R G Gosden's paper describing restoration of fertility in oophorectomised sheep, and for decades previously by others in smaller mammals. Clinically this approach has shown great success. Many healthy children have been born from eggs cryopreserved with the Kuwayama egg vitrification technique for non-medical (social) indications, but until now very few patients with cancer have achieved pregnancy with cryopreserved eggs. Often, oncologists do not wish to delay cancer treatment while the patient goes through multiple ovarian stimulation cycles to retrieve eggs, and the patient can only start using the oocytes after full recovery from cancer. Ovarian stimulation and egg retrieval is not a barrier for patients without cancer who wish to delay childbearing, which makes oocyte cryopreservation increasingly popular to overcome an age-related decline in fertility. Cryopreservation of ovarian tissue is an option if egg cryopreservation is ruled out. More than 35 babies have been born so far with cryopreserved ovarian tissue in patients with cancer who have had a complete return of hormonal function, and fertility to baseline. Both egg and ovarian tissue cryopreservation might be ready for application to the preservation of fertility not only in patients with cancer but also in countering the increasing incidence of age-related decline in female fertility.
自 1994 年以来，人们一直在研究通过冷冻卵子或卵巢组织来保存癌症患者的生育能力，R.G. Gosden 的论文描述了对卵巢切除的绵羊进行生育力恢复的研究，在此之前几十年，其他研究人员也在较小的哺乳动物中进行了相关研究。临床上，这种方法已经取得了巨大的成功。许多健康的孩子都是通过 Kuwayama 卵子玻璃化技术冷冻的卵子生育的，这些孩子的生育并非出于医疗（社会）原因，但到目前为止，很少有癌症患者通过冷冻卵子成功怀孕。通常，肿瘤学家不希望在患者接受多次卵巢刺激周期以获取卵子的过程中延迟癌症治疗，并且患者只能在癌症完全康复后才能开始使用卵母细胞。对于那些希望推迟生育的没有癌症的患者来说，卵巢刺激和卵子采集并不是障碍，这使得卵母细胞冷冻保存越来越受欢迎，可以克服与年龄相关的生育能力下降。如果冷冻卵子不可行，那么冷冻卵巢组织就是一种选择。迄今为止，已有 35 多名婴儿通过冷冻卵巢组织出生，这些婴儿的癌症患者已经完全恢复了激素功能，生育能力也恢复到了基线水平。冷冻卵子和卵巢组织的方法不仅可以用于癌症患者的生育能力保护，也可以用于应对女性生育能力因年龄增长而逐渐下降的日益增加的发病率。
