Tsai Yi-Yi, Chen Shee-Uan, Shieh Chia-Jen, Yao Yi-Lin, Yang Yu-Shih, Chen Chin-Der
Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
Department of Obstetrics and Gynecology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
J Formos Med Assoc. 2014 Dec;113(12):966-9. doi: 10.1016/j.jfma.2014.08.010. Epub 2014 Oct 5.
We report a live birth after single embryo transfer derived from autologous cryopreserved oocytes of a patient with myelodysplastic syndrome who had undergone allogenic peripheral blood stem cell transplantation (PBSCT). In 2006, a 24-year-old female diagnosed with myelodysplastic syndrome was referred for fertility preservation before she underwent PBSCT. After controlled ovarian stimulation, 38 oocytes were retrieved for cryopreservation using a slow-freezing protocol. She was cured by PBSCT and entered menopause. After seven years, she requested thawing of the oocytes. She was prepared for a thawing cycle using hormone replacement therapy. Twenty-two cryopreserved oocytes were thawed, and 20 (91%) oocytes survived. Thirteen mature oocytes were inseminated by intracytoplasmic sperm injection. Ten (77%) oocytes were normally fertilized and 6 (60%) oocytes developed into blastocysts. Embryo transfer to her own uterus with one blastocyst was performed. Five blastocysts were vitrified. A sonographic exam at 7 weeks of gestation revealed one gestational sac with positive cardiac motion. A normal female baby weighing 2704 g was delivered at 40 weeks of gestation. A successful pregnancy from autologous cryopreserved oocytes is encouraging for cancer patients undergoing fertility preservation. For infertile cancer patients after PBSCT, we suggest the transfer of one embryo to reduce the risk of multiple pregnancies.
我们报告了一例单胚胎移植活产病例，该胚胎源自一名接受异基因外周血干细胞移植（PBSCT）的骨髓增生异常综合征患者的自体冷冻卵母细胞。2006年，一名24岁被诊断为骨髓增生异常综合征的女性在接受PBSCT前被转诊进行生育力保存。经过控制性卵巢刺激后，采用慢速冷冻方案获取了38枚卵母细胞进行冷冻保存。她通过PBSCT治愈并进入绝经期。七年后，她要求解冻卵母细胞。她接受激素替代疗法为解冻周期做准备。解冻了22枚冷冻卵母细胞，其中20枚（91%）存活。13枚成熟卵母细胞通过卵胞浆内单精子注射进行授精。其中10枚（77%）卵母细胞正常受精，6枚（60%）卵母细胞发育成囊胚。将一枚囊胚移植到她自己的子宫。另外5枚囊胚进行了玻璃化冷冻。妊娠7周时的超声检查显示有一个妊娠囊且有胎心搏动。妊娠40周时分娩出一名体重2704克的正常女婴。自体冷冻卵母细胞成功妊娠对于接受生育力保存的癌症患者来说是令人鼓舞的。对于PBSCT后的不孕癌症患者，我们建议移植一枚胚胎以降低多胎妊娠的风险。
