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119 例癌症患者在卵巢组织采集以进行生育力保存过程中不成熟卵母细胞采集的结局。

Outcome of immature oocytes collection of 119 cancer patients during ovarian tissue harvesting for fertility preservation.

机构信息

IVF Unit, Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

J Assist Reprod Genet. 2018 May;35(5):851-856. doi: 10.1007/s10815-018-1153-1. Epub 2018 Mar 24.

Abstract

PURPOSE

Few clinical options for fertility preservation are available to females with cancer, and data about clinical outcomes is limited. Potential supplementary approaches to fertility preservation include retrieval of immature oocytes followed by in vitro maturation (IVM) and storage. The aim of this study was to evaluate post-thawing outcomes of immature oocytes collected both by transvaginal aspiration and from excised ovarian tissue.

METHODS

We conducted a retrospective cohort study of patients treated in a single tertiary center. We reviewed the records of 119 cancer patients who underwent ovarian tissue cryopreservation and immature oocyte harvesting for fertility preservation. All embryos and oocytes that were frozen and thawed were included in the study. Post-thawing outcomes were evaluated.

RESULTS

Thirty-five stored embryos from eight patients were thawed. Twenty-nine embryos survived (82% survival rate) and were transferred. Six oocytes were thawed, two oocytes survived, and no oocytes were fertilized. Only one PCOS patient became pregnant, resulting in the normal delivery of a healthy baby.

CONCLUSIONS

Although a relatively high number of mature oocytes and embryos can be stored with the combined procedure, the limited rate of pregnancies represents a poor reproductive outcome. Therefore, this approach should be reserved for special groups with limited options.

摘要

目的

患有癌症的女性可选择的生育力保存方案很少,且相关临床结局数据有限。生育力保存的潜在辅助方法包括采集未成熟卵母细胞并进行体外成熟培养(IVM)和储存。本研究旨在评估经阴道抽吸和卵巢组织切除两种途径采集的未成熟卵母细胞解冻后的结局。

方法

我们对单中心的 119 名癌症患者进行了回顾性队列研究,这些患者接受了卵巢组织冷冻保存和未成熟卵母细胞采集以进行生育力保存。所有冷冻和解冻的胚胎和卵母细胞均纳入研究。评估解冻后的结局。

结果

8 名患者的 35 个储存胚胎解冻。29 个胚胎存活(存活率 82%)并进行了移植。解冻了 6 个卵母细胞,2 个卵母细胞存活,但没有受精。只有 1 名多囊卵巢综合征患者怀孕,正常分娩了一个健康婴儿。

结论

尽管联合手术可以储存较多数量的成熟卵母细胞和胚胎,但妊娠率较低,代表了较差的生殖结局。因此,这种方法应保留给选择有限的特殊人群。

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