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体外激活冷冻卵巢组织:一项单臂荟萃分析和系统综述。

In vitro activation of cryopreserved ovarian tissue: A single-arm meta-analysis and systematic review.

机构信息

Research Group for Reproductive Medicine, University of Cologne, Kerpener Str. 34, 50931, Cologne, Germany.

Institute of Biology and Immunology of Reproduction, Tzarigradsko Shosse 73, 1113, Sofia, Bulgaria.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2021 Mar;258:258-264. doi: 10.1016/j.ejogrb.2021.01.014. Epub 2021 Jan 12.

DOI:10.1016/j.ejogrb.2021.01.014
PMID:33485262
Abstract

OBJECTIVE

Primordial follicles in premature ovarian failure (POF) patients are very difficult to be activated spontaneously, so that mature oocytes are difficult to be obtained for in vitro fertilization. The aim of our review is to analyze and to systematize the published data regarding effectiveness of different strategies for in vitro activation of cryopreserved ovarian tissue.

STUDY DESIGN

According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a review of the literature was performed for all relevant full-text articles published in PubMed in English. Meta-analysis conducted using STATA 14.0. The random-effects model was used to combine 8 study results because the examination of heterogeneity was minimal.

RESULTS

One hundred and seventy seven patients after in vitro activation treatment (IVA) of ovarian tissue had accumulatively 26 pregnancies through IVF or natural pregnancy and then produced 18 live births. The random-effects model showed that the total clinical pregnancy and baby born rates reported in 8 studies evidence about effectiveness of IVA.

CONCLUSION

In vitro activation of primordial follicles as a new potential treatment for ovarian disorder patients, can be a promising option for fertility preservation. Drug-free activation of ovarian tissue in comparison with drug-included activation seemed to be more efficient.

摘要

目的

由于卵巢早衰(POF)患者的原始卵泡很难自发激活,因此很难获得体外受精所需的成熟卵母细胞。本综述的目的是分析和系统地总结已发表的关于不同策略对冷冻卵巢组织体外激活效果的数据。

研究设计

根据系统评价和荟萃分析的首选报告项目(PRISMA)指南,对发表在 PubMed 上的所有相关英文全文文章进行了文献综述。使用 STATA 14.0 进行荟萃分析。由于异质性检查很小,因此使用随机效应模型合并了 8 项研究结果。

结果

177 名卵巢组织体外激活(IVA)治疗后的患者通过 IVF 或自然妊娠累计获得了 26 次妊娠,随后产生了 18 名活产儿。8 项研究报告的随机效应模型显示,IVA 的总临床妊娠率和婴儿出生率均有证据表明其有效性。

结论

作为一种新的潜在卵巢疾病治疗方法,原始卵泡的体外激活可能是生育力保存的一个有前途的选择。与含药激活相比,无药激活的卵巢组织似乎更有效。

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In vitro activation of cryopreserved ovarian tissue: A single-arm meta-analysis and systematic review.体外激活冷冻卵巢组织:一项单臂荟萃分析和系统综述。
Eur J Obstet Gynecol Reprod Biol. 2021 Mar;258:258-264. doi: 10.1016/j.ejogrb.2021.01.014. Epub 2021 Jan 12.
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Drug-free in vitro activation combined with ADSCs-derived exosomes restores ovarian function of rats with premature ovarian insufficiency.无药物体外激活联合脂肪间充质干细胞来源的外泌体可恢复卵巢早衰大鼠的卵巢功能。
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