Department for Reproductive Medicine, Ghent University Hospital, Ghent, Belgium.
Department of Endocrinology - Center for Sexology and Gender, Ghent University Hospital, Ghent, Belgium.
Fertil Steril. 2021 Oct;116(4):1068-1076. doi: 10.1016/j.fertnstert.2021.03.009. Epub 2021 Apr 5.
To study the feasibility of in vitro maturation of ovarian tissue oocytes for fertility preservation in transgender men on testosterone treatment.
Cross-sectional study SETTING: University hospital PATIENT(S): Eighty-three transgender men enrolled from November 2015 to January 2019 INTERVENTION(S): In vitro maturation of cumulus-oocyte complexes (COCs) harvested at the time of gender confirmation surgery, and fertilization through intracytoplasmic sperm injection.
MAIN OUTCOME MEASURE(S): In vitro maturation, fertilization, and blastulation rates; comparison of morphokinetics with vitrified-warmed oocytes; and analysis of the genetic profiles of embryos.
association between serum hormone levels; COCs' morphologic characteristics, and vitrification rate.
RESULT(S): All participants were on testosterone treatment for a median of 83 (64[Quartile 1]; 113.2[Quartile 2]) weeks. A total of 1,903 COCs (mean per participant, 23 ± 15.8) were collected. The in vitro maturation rate was 23.8%, vitrification rate was 21.5%, and survival rate after warming was 72.6% (n = 151). Intracytoplasmic sperm injection was performed in 139 oocytes. The rate of normal fertilized oocytes was 34.5%, and 25 (52.1%) embryos reached day 3. One blastocyst was achieved on day 5. Aberrant cleavage patterns and early embryo arrest were observed in 22 (45.8%) and 44 (91.7%) zygotes, respectively. Compared with vitrified-warmed donor oocytes, a delay was observed in pronuclei disappearance, t2 (time to reach 2 cell stage) timings, and CC1 (the duration of the 1st cell cycle) and SS3 (synchronization of cleavage pattern (calculated as t8-t5) time intervals. A normal genetic pattern was seen in 42% embryos. The proportion of vitrified oocytes was negatively associated with progesterone (odds ratio, 0.76) and positively associated with antimüllerian hormone serum levels (odds ratio, 1.23). The highest vitrification rate was achieved by the morphologic characteristic 344 at day 0 and by 433 at day 2.
CONCLUSION(S): Ovarian tissue oocytes matured in vitro show low developmental capacity in transgender men, when collected under testosterone treatment.
研究在接受睾酮治疗的跨性别男性中，通过体外成熟卵巢组织卵母细胞进行生育力保存的可行性。
横断面研究
大学医院
2015 年 11 月至 2019 年 1 月期间招募的 83 名跨性别男性
在性别确认手术后收获的卵丘-卵母细胞复合物（COCs）进行体外成熟，并通过胞浆内精子注射受精。
体外成熟、受精和囊胚形成率；与玻璃化冷冻-解冻卵母细胞的形态动力学比较；分析胚胎的遗传特征。
血清激素水平与 COC 形态特征和玻璃化率的相关性。
所有参与者均接受睾酮治疗，中位数为 83（64[四分位距 1]；113.2[四分位距 2]）周。共采集了 1903 个 COC（每个参与者的平均值为 23±15.8）。体外成熟率为 23.8%，玻璃化率为 21.5%，解冻后存活率为 72.6%（n=151）。对 139 个卵母细胞进行了胞浆内精子注射。正常受精卵母细胞的比率为 34.5%，25（52.1%）个胚胎发育到第 3 天。第 5 天获得一个囊胚。22（45.8%）个受精卵和 44（91.7%）个受精卵观察到异常卵裂模式和早期胚胎停滞。与玻璃化冷冻-解冻的供体卵母细胞相比，观察到原核消失、t2（达到 2 细胞阶段的时间）时间和 CC1（第 1 个细胞周期的持续时间）和 SS3（卵裂模式同步（计算为 t8-t5）时间间隔）的延迟。42%的胚胎显示正常的遗传模式。玻璃化卵母细胞的比例与孕酮呈负相关（比值比，0.76），与抗苗勒管激素血清水平呈正相关（比值比，1.23）。在第 0 天的形态特征 344 和第 2 天的 433 时获得最高的玻璃化率。
在接受睾酮治疗的跨性别男性中，当采集卵巢组织卵母细胞进行体外成熟时，其发育能力较低。
