Rivas Leonel Ellen Cristina, Lucci Carolina M, Amorim Christiani A
Institut de Recherche Expérimentale et Clinique, Pôle de Recherche en Gynécologie, Université Catholique de Louvain, Brussels, Belgium.
Institute of Biosciences, Department of Biology, Humanities and Exact Sciences, São Paulo State University, São José do Rio Preto, Brazil.
Transfus Med Hemother. 2019 Jun;46(3):173-181. doi: 10.1159/000499054. Epub 2019 Apr 9.
Cryopreservation of human ovarian tissue has been increasingly applied worldwide to safeguard fertility in cancer patients, notably in young girls and women who cannot delay the onset of their treatment. Moreover, it has been proposed to patients with benign pathologies with a risk of premature ovarian insufficiency. So far, more than 130 live births have been reported after transplantation of cryopreserved ovarian tissue, and almost all patients recovered their ovarian function after tissue reimplantation.
This review aims to summarize the recent results described in the literature regarding human ovarian tissue cryopreservation in terms of methods and main results obtained so far. To cryopreserve human ovarian tissue, most studies describe a slow freezing/rapid thawing protocol, which is usually an adaptation of a protocol developed for sheep ovarian tissue. Since freezing has been shown to have a deleterious effect on ovarian stroma and granulosa cells, various research groups have been vitrifying ovarian tissue. Despite promising results, only 2 babies have been born after transplantation of vitrified/warmed ovarian tissue. Optimization of both cryopreservation strategies as well as thawing/warming protocols is therefore necessary to improve the survival of follicles in cryopreserved ovarian tissue.
Human ovarian tissue cryopreservation has been successfully applied worldwide to preserve fertility in patients with malignant or nonmalignant pathologies that have a detrimental effect on fertility. Human ovarian tissue cryopreservation could also be applied as an alternative to postpone pregnancy or menopause in healthy women. Slow freezing and vitrification procedures have been applied to cryopreserve human ovarian tissue, but both alternatives require optimization.
人类卵巢组织冷冻保存已在全球范围内越来越多地应用于保护癌症患者的生育能力，尤其是那些不能推迟治疗开始时间的年轻女孩和女性。此外，对于有卵巢早衰风险的良性疾病患者也有应用。到目前为止，已有超过130例冷冻保存卵巢组织移植后活产的报道，并且几乎所有患者在组织重新植入后恢复了卵巢功能。
本综述旨在总结文献中描述的关于人类卵巢组织冷冻保存的方法及目前所取得的主要成果。为冷冻保存人类卵巢组织，大多数研究描述了一种慢速冷冻/快速解冻方案，这通常是对为绵羊卵巢组织开发的方案的一种改编。由于冷冻已被证明对卵巢基质和颗粒细胞有有害影响，各个研究团队一直在对卵巢组织进行玻璃化处理。尽管取得了有前景的结果，但玻璃化/复温卵巢组织移植后仅出生了2例婴儿。因此，优化冷冻保存策略以及解冻/复温方案对于提高冷冻保存卵巢组织中卵泡的存活率是必要的。
人类卵巢组织冷冻保存已在全球范围内成功应用于保护患有对生育能力有不利影响的恶性或非恶性疾病患者的生育能力。人类卵巢组织冷冻保存也可作为健康女性推迟妊娠或绝经的一种替代方法。慢速冷冻和玻璃化程序已应用于冷冻保存人类卵巢组织，但这两种方法都需要优化。
