镰状细胞病患者在接受根治性干细胞移植前进行卵巢刺激以保存生育能力期间发生急性疼痛危象：病例报告和文献复习。
Acute pain crisis in a patient with sickle cell disease undergoing ovarian simulation for fertility preservation prior to curative stem cell transplantation: case report and literature review.
机构信息
Division of Reproductive Endocrinology, Levine Cancer Institute, Carolinas Healthcare System, Charlotte, NC, USA.
The Women's Institute, 1025 Morehead Medical Dr. Suite 500, Charlotte, NC, 28204, USA.
出版信息
J Assist Reprod Genet. 2017 Nov;34(11):1445-1448. doi: 10.1007/s10815-017-1008-1. Epub 2017 Aug 11.
Abstract
PURPOSE
Hematopoietic stem cell transplantation (HSCT) is a cure for sickle cell disease (SCD) but frequently results in permanent sterility. The complications associated with oocyte cryopreservation and risks of future pregnancy are increased in SCD patients. This case report discusses risk reduction strategies and includes a literature review of pregnancy after HSCT.
CASE
A 23-year-old woman underwent ovarian stimulation for fertility preservation resulting in cancelation due to acute pain crisis. She underwent a successful oocyte retrieval after exchange transfusion to decrease her hemoglobin S to 30%. This is the second report of a pain crisis in a woman with SCD undergoing oocyte banking.
CONCLUSION(S): Women with SCD undergoing fertility preservation may be at increased risk of complications from ovarian stimulation. Risks in pregnancy after HSCT should also be considered before proceeding with fertility preservation.
摘要
目的
造血干细胞移植（HSCT）是治疗镰状细胞病（SCD）的方法，但常导致永久性不育。SCD 患者的卵母细胞冷冻保存相关并发症和未来妊娠风险增加。本病例报告讨论了降低风险的策略，并对 HSCT 后妊娠进行了文献回顾。
病例
一名 23 岁女性因急性疼痛危象进行生育力保存的卵巢刺激，由于该危象取消了刺激。在进行换血以将血红蛋白 S 降低至 30%后，她成功地进行了卵母细胞采集。这是 SCD 女性进行卵母细胞冻存过程中出现疼痛危象的第二份报告。
结论
接受生育力保存的 SCD 女性可能面临卵巢刺激相关并发症的风险增加。在进行生育力保存之前，还应考虑 HSCT 后妊娠的风险。
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