Laboratory of Reproductive Biology, Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, Copenhagen, Denmark.
The Fertility Clinic, Department of Gynecology and Obstetrics, Zealand University Hospital, Køge, Denmark.
Fertil Steril. 2019 Nov;112(5):908-921. doi: 10.1016/j.fertnstert.2019.07.008. Epub 2019 Oct 6.
To systematically review reproductive outcomes of assisted reproductive technology (ART) treatment in women transplanted with frozen-thawed ovarian tissue.
Systematic review in accordance with guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Not applicable.
PATIENT(S): Women undergoing ovarian tissue transplantation (OTT) and subsequent ART.
INTERVENTION(S): Literature search in PubMed and Scopus databases.
MAIN OUTCOME MEASURE(S): Time from OTT to initiation of ART, stimulation protocol, and conventional ART outcome measures.
RESULT(S): Twenty studies (including 15 case reports), specifying ART treatments and outcomes of 40 women undergoing OTT were identified. Multiple stimulation protocols were applied, with the modified natural cycle as the most frequently used. In total, 195 ART cycles were performed (4.0 cycles per patient) resulting in 1.5 follicles and 1.0 mature oocyte retrieved per cycle. Empty follicle rates ranged from 23% to 35% in the three largest cohort studies. Twenty-five women (62.5%) had one or more pregnancies, of which 28.6% were lost, resulting in a total of 20 live births (22 children). Overall the pregnancy rates varied from 3.9% to 19.3% and live-birth rates from 3.9% to 14.0% per cycle in the three cohort studies. Fertility treatment was initiated shortly after OTT in some centers, while others awaited natural conception before embarking on ART treatment.
CONCLUSION(S): The reported pregnancy and live-birth rates for women undergoing OTT and ART were considerably lower than those of the general in vitro fertilization (IVF) population, corresponding to patients with poor ovarian reserve. In general, ART outcomes are underreported, and there is a lack of consensus regarding the timing of ART in relation to OTT and the type of ovarian stimulation protocol.
系统评价冻融卵巢组织移植（OTT）后接受辅助生殖技术（ART）治疗的女性的生殖结局。
根据系统评价和荟萃分析的首选报告项目（PRISMA）指南进行系统评价。
不适用。
接受卵巢组织移植（OTT）和随后的 ART 的女性。
在 PubMed 和 Scopus 数据库中进行文献检索。
从 OTT 到开始 ART 的时间、刺激方案和常规 ART 结局指标。
共确定了 20 项研究（包括 15 项病例报告），其中有 40 名接受 OTT 的女性报告了 ART 治疗和结局。应用了多种刺激方案，最常用的是改良自然周期。共进行了 195 个 ART 周期（每个患者 4.0 个周期），每个周期平均取回 1.5 个卵泡和 1.0 个成熟卵母细胞。在最大的三个队列研究中，空卵泡率范围为 23%至 35%。25 名女性（62.5%）有一次或多次妊娠，其中 28.6%妊娠丢失，总共 20 名活产（22 名儿童）。在三个队列研究中，总的妊娠率从 3.9%到 19.3%不等，活产率从 3.9%到 14.0%不等。一些中心在 OTT 后不久就开始进行生育治疗，而另一些中心则在开始 ART 治疗之前等待自然受孕。
接受 OTT 和 ART 的女性的妊娠和活产率明显低于一般体外受精（IVF）人群，与卵巢储备不良的患者相对应。一般来说，ART 结局报告不足，关于 ART 与 OTT 的时间关系以及卵巢刺激方案类型，尚无共识。
