Lipovac Markus, Herzog Julia, Imhof Martin
Karl Landsteiner Institut für zellorientierte Therapie in der Gynäkologie, Wiener Ring 3-5, 2100 Korneuburg, Österreich.
J Gynakol Endokrinol. 2020;30(4):148-152. doi: 10.1007/s41974-020-00160-w. Epub 2020 Oct 14.
Retransplantation of cryopreserved ovarian tissue has become an established method of restoring autologous hormone production and fertility after radiotherapy and/or chemotherapy for underlying oncological disease in women of reproductive age and has so far led to more than 170 births worldwide.
In 2013, the 31-year-old patient developed adenocarcinoma of the uterine cervix, pT1b1V0L0. In January 2014, an extended hysterectomy with lymph node dissection and bilateral adnexectomy were performed. At the patient's request, ovarian tissue was cryopreserved 2 days previously. In November 2019, the retransplantation of two ovarian tissue pieces along the brachial fascia of the left forearm was performed, with no recurrence for 5 years under ongoing hormone replacement therapy (HRT). At 1 month following retransplantation, the patient stopped taking HRT, and 3 months later proper function of the retransplanted tissue could be demonstrated by checking gonadotropins and E2 levels. There was a clear swelling in the area of the retransplantation site, and three vital follicles could be visualized during an ultrasound examination in May 2020.
This is the first successful retransplantation of cryopreserved ovarian tissue to restore autologous hormone production in a cervical cancer patient in Austria. Based on blood, ultrasound and cytological examinations, not to mention the patient's personal well-being, functionality of the retransplanted tissue could be demonstrated even at 6 months after the procedure. Finally, the authors would like to highlight the importance of informing and consulting young patients with tumor diseases on the various possibilities of fertility preservation.
对于育龄期女性因潜在肿瘤疾病接受放疗和/或化疗后,冷冻保存的卵巢组织再移植已成为恢复自体激素分泌和生育能力的既定方法,迄今为止,全球已有超过170例婴儿通过这种方式出生。
2013年,一名31岁患者被诊断为子宫颈腺癌,分期为pT1b1V0L0。2014年1月,患者接受了广泛子宫切除术、淋巴结清扫术和双侧附件切除术。应患者要求,术前2天对卵巢组织进行了冷冻保存。2019年11月,将两块卵巢组织沿着左前臂肱筋膜进行了再移植,在持续激素替代治疗(HRT)下5年无复发。再移植后1个月,患者停止服用HRT,3个月后,通过检查促性腺激素和E2水平证实再移植组织功能正常。再移植部位明显肿胀,2020年5月超声检查可见三个有活力的卵泡。
这是奥地利首例成功进行冷冻保存卵巢组织再移植以恢复宫颈癌患者自体激素分泌的病例。基于血液、超声和细胞学检查,更不用说患者的个人健康状况,即使在术后6个月也能证明再移植组织的功能。最后,作者强调了告知和咨询患有肿瘤疾病的年轻患者关于生育力保存各种可能性的重要性。