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女性生育力保存:癌症对卵巢功能和卵母细胞质量的影响。

Female fertility preservation: Impact of cancer on ovarian function and oocyte quality.

机构信息

Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy.

Department of Medical and Surgical Science and Translational Medicine, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.

出版信息

Int J Gynaecol Obstet. 2022 Jan;156(1):166-171. doi: 10.1002/ijgo.13702. Epub 2021 Apr 28.

Abstract

OBJECTIVE

To evaluate the influence of cancer on ovarian response and oocyte quality in controlled ovarian hyperstimulation (COH).

METHODS

This prospective study conducted at the Physiopathology of Reproduction and Andrology Unit of Sandro Pertini Hospital enrolled 82 cancer patients undergoing controlled ovarian stimulation (COH) cycles for fertility preservation, and age- and date-matched controls undergoing COH for in vitro fertilization for male-factor infertility from June 2016 to November 2019. The interventions performed were COH, oocyte retrieval, and quality evaluation. Main outcome measures were maximal estradiol levels on the day of human chorionic gonadotropin administration, duration of stimulation, total amount of gonadotropins administered, number of oocytes retrieved, and rates of metaphase 2 oocytes and abnormal oocytes. All data were analyzed using the Statistical Package for the Social Sciences (IBM Corp., Armonk, NY, USA) 22.0.

RESULTS

Intergroup comparisons (82 cancer patients and 180 patients in control group) showed a significant difference in ovarian response, especially for a significant higher number of abnormal oocytes in cancer patients (P < 0.0001). Regression analysis to assess the influence of the neoplastic process, regardless of the type, on ovarian response showed an effect on the main outcome measured due to cancer itself.

CONCLUSION

Cancer influences the ovarian response, particularly the oocyte quality, during COH performed for fertility preservation.

摘要

目的

评估癌症对控制性卵巢刺激(COH)中卵巢反应和卵母细胞质量的影响。

方法

这项前瞻性研究在桑德罗·佩蒂尼医院的生殖病理生理学和男性生育单位进行,纳入了 82 名癌症患者,他们接受控制性卵巢刺激(COH)周期以进行生育保存,以及年龄和日期匹配的因男性因素不孕而接受 COH 进行体外受精的对照组患者。干预措施包括 COH、卵母细胞采集和质量评估。主要观察指标是人绒毛膜促性腺激素给药日的最大雌二醇水平、刺激持续时间、促性腺激素总用量、采集的卵母细胞数量以及中期 2 卵母细胞和异常卵母细胞的比率。所有数据均使用社会科学统计软件包(IBM 公司,纽约州阿蒙克,美国)22.0 进行分析。

结果

组间比较(82 名癌症患者和 180 名对照组患者)显示卵巢反应存在显著差异,尤其是癌症患者异常卵母细胞数量显著增加(P<0.0001)。回归分析评估了肿瘤过程(无论类型如何)对卵巢反应的影响,结果显示癌症本身对主要测量结果有影响。

结论

癌症会影响 COH 期间的卵巢反应,尤其是卵母细胞质量,以进行生育保存。

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