Donnez Jacques, Manavella Diego D, Dolmans Marie-Madeleine
Université Catholique de Louvain, Brussels, Belgium -
Société de Recherche pour l'Infertilité (SRI), Brussels, Belgium -
Minerva Ginecol. 2018 Aug;70(4):424-431. doi: 10.23736/S0026-4784.18.04228-4. Epub 2018 Apr 11.
Fertility preservation has emerged as a field of growing interest thanks to increasingly effective cancer treatments in women. For young women with good prospects of surviving cancer, fertility preservation counseling before gonadotoxic treatment is imperative to offer them a potential chance of future childbearing. Ovarian tissue cryopreservation and transplantation emerges as a strategy for fertility preservation, especially for prepubertal girls, adolescents and women in whom cancer treatment cannot be delayed. Numerous surgical techniques have been reported and are currently being used for frozen-thawed ovarian tissue reimplantation, but successful approaches all adhere to the same fundamental micro-surgical principles: 1) finding a well vascularized orthotopic transplantation site, and 2) fixing the ovarian tissue by means of stitches, Interceed® and/or fibrin glue. Orthotopic reimplantation has proved to be the most effective technique in terms of resumption of ovarian endocrine function in more than 95% of all reported cases, and fertility restoration in over than 40% of patients in our series.
由于针对女性的癌症治疗方法日益有效，生育力保存已成为一个越来越受关注的领域。对于有望从癌症中存活的年轻女性，在进行性腺毒性治疗前提供生育力保存咨询，对于给予她们未来生育的潜在机会至关重要。卵巢组织冷冻保存和移植成为一种生育力保存策略，尤其适用于青春期前女孩、青少年以及癌症治疗不能延迟的女性。已有众多手术技术被报道且目前正用于冻融卵巢组织再植入，但成功的方法都遵循相同的基本显微手术原则：1）找到一个血管化良好的原位移植部位；2）通过缝线、Interceed®和/或纤维蛋白胶固定卵巢组织。在所有报道的病例中，超过95%的病例显示原位再植入在恢复卵巢内分泌功能方面是最有效的技术，在我们的系列研究中，超过40%的患者实现了生育恢复。
