1 Policlinic of Rheumatology and Hiller Research Unit Rheumatology, Heinrich-Heine-University, Düsseldorf, Germany.
2 Department of Obstetrics/Gynecology and Reproductive Endocrinology and Infertility (UniKiD), Heinrich-Heine-University, Düsseldorf, Germany.
Lupus. 2019 Apr;28(5):675-680. doi: 10.1177/0961203319839482. Epub 2019 Mar 24.
Premature gonadal failure is a common problem in patients with systemic lupus erythematosus (SLE) when gonadotoxic therapies are applied. The preservation of gonadal function and fertility is of great importance to many predominantly young SLE patients. Some fertility preservation methods are well established and well known, whereas others are considered more cautiously. In particular, the cryopreservation of ovarian tissue is a rarely chosen fertility preservation option for SLE patients of (pre)fertile age. We report the first case of successful conception and pregnancy of an SLE patient after autotransplantation of cryopreserved ovarian tissue. A 26-year-old SLE patient decided to undergo cryopreservation of ovarian tissue when receiving cyclophosphamide for lupus nephritis. Tissue removal, preparation, cryopreservation and quality control was performed, as described, according to current state-of-the-art techniques. After 6 years of being in remission using azathioprine and belimumab, her ovarian tissue was autotransplanted because of premature ovarian failure, diagnosed at the age of 32, and a wish to conceive. She conceived spontaneously 8 months later, having a diamniotic-dichoriotic twin pregnancy. The children were born prematurely due to preterm premature rupture of membranes in the 32nd week of gestation; mother and children are doing very well 8 months later. We regard the procedure to be an option worth consideration for our predominantly young SLE patients.
性腺早衰是红斑狼疮（SLE）患者接受性腺毒性治疗时常见的问题。对于大多数年轻的 SLE 患者来说，保持性腺功能和生育能力非常重要。一些生育力保存方法已经得到了很好的确立和认可，而另一些方法则被认为更为谨慎。特别是，冷冻卵巢组织是一种很少被选择的生育力保存方法，适用于有生育能力的年轻 SLE 患者。我们报告了首例 SLE 患者在接受冷冻卵巢组织自体移植后成功受孕并怀孕的病例。一名 26 岁的 SLE 患者在接受环磷酰胺治疗狼疮性肾炎时决定进行卵巢组织冷冻保存。按照目前的最新技术，我们按照描述进行了组织切除、准备、冷冻保存和质量控制。在使用硫唑嘌呤和贝利尤单抗缓解 6 年后，由于 32 岁时被诊断为卵巢早衰以及渴望怀孕，她进行了卵巢组织自体移植。8 个月后，她自然受孕，怀了一对单卵双胎妊娠。由于 32 周胎膜早破，孩子早产；8 个月后母亲和孩子都恢复得很好。我们认为该程序是我们年轻的 SLE 患者的一个值得考虑的选择。
