Hornshøj Greve Vinnie, Dueholm Margit, Mamsen Linn Salto, Kristensen Stine Gry, Ernst Erik, Andersen Claus-Yding
Department of Obstetrics and Gynecology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 82, 8200 Aarhus, Denmark.
Laboratory of Reproductive Biology, The Juliane Marie Centre for Women, Children and Reproduction, University Hospital of Copenhagen, 2100 Copenhagen, Denmark.
J Clin Med. 2021 Nov 9;10(22):5217. doi: 10.3390/jcm10225217.
Ovarian tissue cryopreservation (OTC) and transplantation of frozen/thawed ovarian tissue (OTT) are used for fertility preservation in girls and women. Here, we evaluated the hormonal characteristics of women with or without postmenopausal levels of FSH at the time of OTT to study differences and conditions that best support the initiation of ovarian function. A total of 74 women undergoing OTT ( = 51 with menopausal levels of FSH; = 23 with premenopausal levels) were followed by measurements of FSH, LH, AMH, and oestradiol. Concentrations of FSH and LH returned to premenopausal levels after 20 weeks on average, with a concomitant increase in oestradiol. Despite resumption of ovarian activity, AMH concentrations were in most instances below the detection limit in the menopausal group, suggesting a low ovarian reserve. Despite a higher age in the premenopausal group, they more often experienced an AMH increase than the menopausal group, suggesting that conditions in the premenopausal ovary better sustain follicle survival, perhaps due to the higher concentrations of oestradiol. Collectively, this study highlights the need for improving follicle survival after OTT. Age and the amount of tissue transplanted are important factors that influence the ability to regain ovarian activity and levels of FSH may need to be downregulated and oestradiol increased prior to OTT.
卵巢组织冷冻保存（OTC）及冻融卵巢组织移植（OTT）用于女孩和女性的生育力保存。在此，我们评估了OTT时促卵泡生成素（FSH）处于绝经后水平或未处于绝经后水平的女性的激素特征，以研究最有利于启动卵巢功能的差异和条件。对总共74名接受OTT的女性（n = 51名FSH处于绝经后水平；n = 23名FSH处于绝经前水平）进行了FSH、促黄体生成素（LH）、抗缪勒管激素（AMH）和雌二醇的测量随访。FSH和LH的浓度平均在20周后恢复到绝经前水平，同时雌二醇水平升高。尽管卵巢活动恢复，但在绝经组中，大多数情况下AMH浓度低于检测限，提示卵巢储备较低。尽管绝经前组年龄较大，但与绝经组相比，她们更常出现AMH升高，这表明绝经前卵巢的条件能更好地维持卵泡存活，可能是由于雌二醇浓度较高。总体而言，本研究强调了改善OTT后卵泡存活的必要性。年龄和移植组织的量是影响恢复卵巢活动能力的重要因素，且在OTT前可能需要下调FSH水平并提高雌二醇水平。
