Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Fertil Steril. 2019 Aug;112(2):315-322. doi: 10.1016/j.fertnstert.2019.03.026. Epub 2019 May 2.
To evaluate in vitro maturation (IVM) efficacy and oocyte retrieval rates after ovarian tissue cryopreservation in young premenarche girls facing chemo- and radiotherapy.
A retrospective cohort study.
University-affiliated tertiary medical center.
PATIENT(S): A total of 84 chemotherapy-naïve patients ages 0-18 years referred for fertility preservation between 2004 and 2017: 33 premenarche and 51 postmenarche patients.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): IVM in the pre- and postmenarche groups and in the subgroups of very young (up to age 5 years) and older (5-10 years) premenarche girls.
The number of oocytes retrieved did not significantly differ between the postmenarche and premenarche groups (10.8 ± 8.5 and 8.1 ± 6.8, respectively). However, the overall IVM rate was significantly higher in the postmenarche group (28.2% vs. 15.5%, respectively; odds ratio = 0.47). A separate analysis for patients up to 5 years of age demonstrated significantly lower oocyte yield compared with the older (5-10 years) premenarche girls (4.7 ± 5.2 vs.10.3 ± 7.0 oocytes, respectively) and much lower IVM rates (4.9% and 18.2%, respectively). Correlation of age with number of retrieved and matured oocytes showed a positive significant correlation (r = 0.45 and r = 0.64, respectively).
IVM performed after ovarian tissue cryopreservation in premenarche girls and specifically in very young girls (4 years and younger) yields substantially decreased maturation rates compared with postmenarche patients, raising a question as to the utility of current IVM technique in this age group. Further studies are required to assess modification of the IVM technique for young girls.
评估在面临化疗和放疗的年轻初潮前女孩中，卵巢组织冷冻保存后的体外成熟（IVM）效果和卵母细胞获取率。
回顾性队列研究。
大学附属三级医疗中心。
2004 年至 2017 年期间，共有 84 名化疗初治的 0-18 岁患者因生育力保存而转诊：33 名初潮前和 51 名初潮后患者。
无。
在初潮前和初潮后组以及非常年轻（≤5 岁）和年龄较大（5-10 岁）初潮前女孩的亚组中进行 IVM。
卵母细胞获取数量在初潮后和初潮前组之间无显著差异（分别为 10.8±8.5 和 8.1±6.8）。然而，初潮后组的整体 IVM 率明显更高（分别为 28.2%和 15.5%；优势比=0.47）。对于年龄不超过 5 岁的患者进行单独分析，与年龄较大（5-10 岁）的初潮前女孩相比，卵母细胞产量显著降低（分别为 4.7±5.2 和 10.3±7.0 个卵母细胞），且 IVM 率明显降低（分别为 4.9%和 18.2%）。年龄与获取和成熟卵母细胞数量的相关性呈正显著相关（r=0.45 和 r=0.64）。
在初潮前女孩中进行卵巢组织冷冻保存后的 IVM，特别是在非常年轻的女孩（4 岁及以下）中，与初潮后患者相比，成熟率显著降低，这引发了对当前 IVM 技术在该年龄组中的实用性的质疑。需要进一步研究来评估针对年轻女孩的 IVM 技术的改进。
