University Maternal Hospital, Research Group for Reproductive Medicine and IVF-Laboratory, Department of Obstetrics and Gynaecology, Cologne University, Cologne, Germany.
Institute of Biology and Immunology of Reproduction, Sofia, Bulgaria.
Hum Fertil (Camb). 2022 Oct;25(4):651-661. doi: 10.1080/14647273.2021.1885756. Epub 2021 Mar 1.
The proportion of cancer patients that survive is increasing because of improvements in cancer therapy. However, some cancer treatments, such as chemo- and radio-therapies, can cause considerable damage to reproductive function. The issue of fertility is paramount for women of childbearing age once they are cured from cancer. For those patients with prepubertal or haematogenous cancer, the possibilities of conventional fertility treatments, such as oocyte or embryo cryopreservation and transplantation, are limited. Moreover, ovarian tissue cryopreservation as an alternative to fertility preservation has limitations, with a risk of re-implanting malignant cells in patients who have recovered from potentially fatal malignant disease. One possible way to restore fertility in these patients is to mimic artificially the function of the natural organ, the ovary, by grafting isolated follicles embedded in a biological scaffold to their native environment. Construction and cryopreservation of an artificial ovary might offer a safer alternative option to restore fertility for those who cannot benefit from traditional fertility preservation techniques. This review considers the protocols for constructing an artificial ovary, summarises advances in the field with potential clinical application, and discusses future trends for cryopreservation of these artificial constructions.
由于癌症治疗的进步，癌症患者的存活率正在提高。然而，一些癌症治疗方法，如化疗和放疗，会对生殖功能造成相当大的损害。对于癌症治愈后的育龄妇女来说，生育问题至关重要。对于那些患有青春期前或血源性癌症的患者，传统的生育治疗方法，如卵母细胞或胚胎冷冻保存和移植的可能性有限。此外，卵巢组织冷冻保存作为一种生育保存的替代方法存在局限性，因为在从潜在致命的恶性疾病中康复的患者中，存在重新植入恶性细胞的风险。一种可能的方法是通过将嵌入生物支架中的分离卵泡移植到其自然环境中，人工模拟天然器官——卵巢的功能，从而恢复这些患者的生育能力。人工卵巢的构建和冷冻保存可能为那些不能从传统生育保存技术中获益的人提供更安全的恢复生育能力的选择。本文综述了构建人工卵巢的方案，总结了该领域具有潜在临床应用的进展，并讨论了这些人工结构冷冻保存的未来趋势。
