Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.
Gynecology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Reproduction. 2019 Nov;158(5):F15-F25. doi: 10.1530/REP-18-0536.
Increasing numbers of patients are now surviving previously fatal malignant diseases, so for women of childbearing age, fertility concerns are paramount once they are cured. However, the treatments themselves, namely chemo- and radiotherapy, can cause considerable damage to endocrine and reproductive functions, often leaving these women unable to conceive. When such gonadotoxic therapy cannot be postponed due to the severity of the disease or for prepubertal girls, the only way to preserve fertility is cryobanking their ovarian tissue for future use. Unfortunately, with some types of cancer, there is a risk of reimplanting malignant cells together with the frozen-thawed tissue, so it is not recommended. A safer approach involves grafting isolated preantral follicles back to their native environment inside a specially created transplantable artificial ovary for their protection. This bioengineered ovary must mimic the natural organ and therefore requires an appropriate scaffold to encapsulate not only isolated follicles, but also autologous ovarian cells, which are needed for follicles to survive and develop. Here we review the indications for use of this artificial ovary and advances in the field that are bringing us ever closer to clinical implementation.
现在越来越多的患者能够存活先前致命的恶性疾病，因此对于育龄妇女来说，一旦治愈，生育问题至关重要。然而，治疗本身，即化疗和放疗，会对内分泌和生殖功能造成相当大的损害，往往使这些女性无法怀孕。如果由于疾病的严重程度或青春期前女孩的原因而不能推迟这种性腺毒性治疗，那么保存生育能力的唯一方法是冷冻保存她们的卵巢组织以备将来使用。不幸的是，对于某些类型的癌症，存在与冷冻-解冻组织一起重新植入恶性细胞的风险，因此不建议这样做。一种更安全的方法涉及将分离的原始卵泡移植回其在专门创建的可移植人工卵巢中的天然环境中，以进行保护。这种生物工程卵巢必须模拟天然器官，因此需要一个合适的支架来封装不仅是分离的卵泡，还有自体卵巢细胞，这是卵泡生存和发育所必需的。在这里，我们回顾了这种人工卵巢的使用指征和该领域的进展，这些进展使我们越来越接近临床实施。
