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男性生育力保存:在卵巢组织处理时采集的冷冻-解冻体外成熟卵母细胞显示正常的减数分裂纺锤体。

Fertility preservation for trans men: frozen-thawed in vitro matured oocytes collected at the time of ovarian tissue processing exhibit normal meiotic spindles.

机构信息

Department for Reproductive Medicine, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.

Department of Pharmaceutics, Laboratory of General Biochemistry and Physical Pharmacy, Ghent University, Harelbekestraat 72, 9000, Ghent, Belgium.

出版信息

J Assist Reprod Genet. 2017 Nov;34(11):1449-1456. doi: 10.1007/s10815-017-0976-5. Epub 2017 Jun 24.

Abstract

PURPOSES

At the moment of sex reassignment surgery (SRS), the ovarian tissue is sometimes cryopreserved as fertility preservation option for female-to-male trans men, also called trans men. During this preparation, cumulus-oocyte-complexes (COCs) can be found and in vitro matured. It is not known if these oocytes are developmentally competent. In order to use these oocytes for fertility preservation and subsequent fertilization, a normal spindle structure before and after vitrification is necessary.

METHODS

A total of 680 COCs were collected from trans men (n = 16) at the time of SRS and after testosterone treatment. The COCs were subjected to in vitro maturation and those that reached the metaphase II stage (MII) were collected and split into two groups; group 1 was immediately fixed for spindle staining and group 2 was first vitrified and warmed followed by spindle staining. Statistical analysis was performed by Fisher's exact test.

RESULTS

After 48 h in vitro maturation, 38.1% of COCs were at MII stage. Those oocytes were split in two groups: (1) 126 MII oocytes in the noncryopreservation group and (2) 133 MII oocytes underwent cryopreservation through vitrification. The oocyte survival rate, after 2 h warming, was 67.7%. Both the noncryopreserved and the vitrified group showed comparable results concerning normal spindle structure and chromosomes alignment, 85.7% vs. 92.2% (P = 0.27).

CONCLUSIONS

Spindle structure analysis and chromosomal alignment after vitrification seem normal in in vitro matured COCs collected during the tissue processing of ovaries in trans men at the time of SRS. The MII oocytes do not seem to be morphologically affected by prolonged testosterone treatment.

摘要

目的

在性别重置手术(SRS)时,有时会冷冻卵巢组织作为女性到男性跨性别男性(也称为跨性别男性)的生育保存选择。在这个准备过程中,可以发现和体外成熟卵丘-卵母细胞复合物(COCs)。目前尚不清楚这些卵子是否具有发育能力。为了使用这些卵子进行生育保存和随后的受精,在玻璃化前后需要正常的纺锤体结构。

方法

共从 16 名 SRS 时和睾酮治疗后的跨性别男性中收集了 680 个 COCs。COCs 进行体外成熟,达到中期 II 期(MII)的 COCs 被收集并分为两组;第 1 组立即固定用于纺锤体染色,第 2 组先进行玻璃化和解冻,然后进行纺锤体染色。Fisher 精确检验用于统计分析。

结果

体外成熟 48 小时后,38.1%的 COCs 处于 MII 期。这些卵母细胞分为两组:(1)未冷冻保存组的 126 个 MII 卵母细胞和(2)通过玻璃化进行冷冻保存的 133 个 MII 卵母细胞。解冻后 2 小时的卵母细胞存活率为 67.7%。未冷冻保存组和玻璃化组的纺锤体结构和染色体排列结果相似,分别为 85.7%和 92.2%(P=0.27)。

结论

在 SRS 时卵巢组织处理过程中收集的体外成熟 COCs 进行玻璃化后,纺锤体结构分析和染色体排列似乎正常。MII 卵母细胞似乎不会因长期睾酮治疗而在形态上受到影响。

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