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癌症诊断时使用冷冻卵子或胚胎后女性幸存者的活产率:十年经验的回顾性研究。

Live birth rate after use of cryopreserved oocytes or embryos at the time of cancer diagnosis in female survivors: a retrospective study of ten years of experience.

机构信息

Reproductive Biology Unit CECOS, Antoine Béclère Hospital APHP, Paris-Saclay University, 157 rue de la porte de Trivaux, Clamart, 92140, Paris, France.

Laboratory of Development of the Gonads, UMRE008 Genetic Stability Stem Cells and Radiation, Paris University, Paris-Saclay University, CEA, F-92265 Fontenay-aux-Roses, Paris, France.

出版信息

J Assist Reprod Genet. 2021 Jul;38(7):1767-1775. doi: 10.1007/s10815-021-02168-3. Epub 2021 Apr 1.

Abstract

PURPOSE

The aim of this study was to evaluate the outcomes of frozen oocytes or embryos cryopreserved after controlled ovarian stimulation (COS) or in vitro maturation (IVM) for female cancer patients who underwent a fertility preservation (FP) prior to gonadotoxic therapy.

METHODS

A retrospective cohort study from 2009 to December 2017 was conducted. Among the 667 female cancer patients who underwent oocytes or embryos cryopreservation for FP, 40 (6%) have returned to the fertility clinic between 2011 and 2019 to use their frozen material after being cured. We compared these thaw cycles outcomes according to the techniques used at the time of cryopreservation.

RESULTS

Among the 40 women cancer survivors who used their cryopreserved material, thirty patients have benefited from at least one embryo transfer. Ten patients did not have an embryo transfer since the oocytes did not survive after the thawing process or because no embryo was obtained after fertilization. We related three live births following FP using IVM (two from frozen oocytes and one after embryo cryopreservation). Five live births were obtained when COS was performed at the time of FP (one from frozen oocytes and four after embryo cryopreservation).

CONCLUSIONS

Our preliminary results, although they are obtained in a small sample, are encouraging and show that different FP techniques can be used in female cancer patients and lead to live births. IVM is one of the options available that does not delay the start of chemotherapy or if ovarian stimulation using gonadotropins is contraindicated.

摘要

目的

本研究旨在评估在接受性腺毒性治疗前进行生育力保存(FP)的女性癌症患者,经控制性卵巢刺激(COS)或体外成熟(IVM)冷冻保存卵母细胞或胚胎后的结局。

方法

对 2009 年至 2017 年 12 月进行的回顾性队列研究进行了分析。在 667 名接受卵母细胞或胚胎冷冻保存以进行 FP 的女性癌症患者中,有 40 名(6%)在治愈后于 2011 年至 2019 年期间返回生育力诊所使用其冷冻材料。我们根据冷冻保存时使用的技术比较了这些解冻周期的结局。

结果

在使用冷冻保存材料的 40 名癌症幸存者中,有 30 名患者至少进行了一次胚胎移植。有 10 名患者没有进行胚胎移植,因为解冻过程后卵母细胞没有存活,或者因为受精后没有获得胚胎。我们通过 FP 时使用 IVM(从冷冻卵母细胞中获得 2 个,从胚胎冷冻中获得 1 个)获得了 3 例活产。当 FP 时进行 COS 时获得了 5 例活产(从冷冻卵母细胞中获得 1 个,从胚胎冷冻中获得 4 个)。

结论

尽管我们的初步结果是在小样本中获得的,但令人鼓舞,表明不同的 FP 技术可用于女性癌症患者,并导致活产。IVM 是一种可用的选择,它不会延迟化疗的开始,或者如果使用促性腺激素进行卵巢刺激是禁忌的。

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