Rodriguez-Wallberg Kenny A, Karlström Per-Olof, Rezapour Masoumeh, Castellanos Enrique, Hreinsson Julius, Rasmussen Carsten, Sheikhi Mona, Ouvrier Bettina, Bozóky Béla, Olofsson Jan I, Lundqvist Monalill, Hovatta Outi
Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden; Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden.
Acta Obstet Gynecol Scand. 2015 Mar;94(3):324-8. doi: 10.1111/aogs.12568. Epub 2015 Feb 2.
We report the first successful transplantation of cryopreserved ovarian cortical tissue into heavily irradiated tissues in a patient who had received sterilizing pelvic radiotherapy (54 Gy) and 40 weeks of intensive high-dose chemotherapy for the treatment of Ewing's sarcoma 14 years earlier. Repeated transplantation procedures were required to obtain fully functional follicular development. Enlargement of the transplants over time and increase of the size of the uterus were demonstrated on sequential ultrasonographic examinations. Eggs of good quality that could be fertilized in vitro were obtained only after a substantial incremental increase of the amount of ovarian tissue transplanted. Single embryo replacement resulted in a normal pregnancy and the birth of a healthy child by cesarean section at full-term. No neonatal or maternal postoperative complications occurred. Women facing high-dose pelvic radiotherapy should not be systematically excluded from fertility preservation options, as is currently the trend.
我们报告了首例将冷冻保存的卵巢皮质组织成功移植到重度放疗组织中的案例。该患者14年前因尤因肉瘤接受了盆腔绝育放疗（54 Gy）以及40周的强化大剂量化疗。为实现完全功能性卵泡发育，需要重复进行移植手术。连续超声检查显示，移植组织随时间逐渐增大，子宫体积也有所增加。仅在大幅增加移植卵巢组织量之后，才获得了可在体外受精的优质卵子。单胚胎移植导致正常妊娠，并通过足月剖宫产诞下一名健康婴儿。术后未出现新生儿或母体并发症。面临高剂量盆腔放疗的女性不应像目前的趋势那样被一概排除在生育力保存选择之外。
