Shirasawa Hiromitsu, Terada Yukihiro
Department of Obstetrics and Gynecology Akita University Graduate School of Medicine Akita Japan.
Reprod Med Biol. 2017 Jun 18;16(3):258-267. doi: 10.1002/rmb2.12042. eCollection 2017 Jul.
In recent years, the importance of fertility preservation (FP) has increased. In vitro maturation (IVM), an important technique in FP, has started to be used in the clinic, but controversies persist regarding this technique. Here, a survey of IVM for FP is provided.
Based on a literature review, the applications of FP, methods of FP, IVM of oocytes that had been collected in vivo and ex vivo, maturation of oocytes after IVM for FP, cryopreservation of oocytes for FP, explanation of the procedures to patients, and recent research on FP using IVM were investigated.
Although IVM for FP remains controversial, the application of FP is expected to expand. Depending on the age and disease status of the patient, various methods of oocyte collection and ovarian stimulation, as well as various needle types and aspiration pressures, have been reported. The maturation rate of IVM in FP ranges widely and requires optimization in the future. In regard to cryopreservation for matured oocytes, the vitrification method is currently recommended.
Regarding FP for patients with cancer, the treatment of cancer is prioritized; thus, the time and use of medicines are often constrained. As several key points regarding IVM remain unclear, well-designed and specific counseling for patients is necessary.
近年来，生育力保存（FP）的重要性日益增加。体外成熟（IVM）作为FP中的一项重要技术已开始应用于临床，但关于该技术的争议仍然存在。本文对用于FP的IVM进行综述。
基于文献回顾，对FP的应用、FP的方法、体内和体外采集卵母细胞的IVM、用于FP的IVM后卵母细胞的成熟、用于FP的卵母细胞冷冻保存、向患者解释操作步骤以及近期使用IVM进行FP的研究进行了调查。
尽管用于FP的IVM仍存在争议，但预计FP的应用将会扩大。根据患者的年龄和疾病状况，已报道了多种卵母细胞采集和卵巢刺激方法，以及各种穿刺针类型和抽吸压力。用于FP的IVM的成熟率差异很大，未来需要进行优化。关于成熟卵母细胞的冷冻保存，目前推荐玻璃化法。
对于癌症患者的FP，癌症治疗是首要任务；因此，时间和药物使用往往受到限制。由于关于IVM的几个关键点仍不明确，有必要为患者提供精心设计的针对性咨询。
