Sirait Batara, Jusuf Ahmad Aulia, Wiweko Budi, Handayani Nining, Aubry Daniel Abidin, Muharam R
Doctoral program, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
Department of Obstetrics and Gynaecology, Faculty of Medicine Universitas Kristen Indonesia, Jakarta, Indonesia.
J Hum Reprod Sci. 2022 Jan-Mar;15(1):3-11. doi: 10.4103/jhrs.jhrs_112_21. Epub 2022 Mar 31.
Fertility preservation through gamete vitrification has become one of the critical strategies to secure a childbearing potential in patients who are diagnosed with cancer or risks of infertility. Preserving the gametes would prevent the deleterious effects of cancer drugs or radiotherapy exposure on the quality of the gametes. Furthermore, fertilisation of vitrified mature human oocytes has lately demonstrated promising results that are reflected in the increased survival rate of thawed oocytes and the resultant clinical pregnancy rate. However, limitations in the cryopreservation of mature oocytes of cancer patients persist. Ovarian stimulation protocols which comprise administering gonadotrophin-releasing hormones could aggravate cancer or delay essential cancer therapy. Considering such circumstances, vitrification of immature oocytes would become a rational option. While the vitrification procedure of mature oocytes has been established, the vitrification of immature oocytes remains controversial due to a low post-thaw maturation and fertilisation rate. Apparent cryoinjuries to the immature oocytes post thawing or warming have been observed in both human and animal model oocytes. An alternative strategy was therefore proposed to improve the effectiveness of utilising immature oocytes for fertility preservation by conducting the oocyte maturation process first before vitrification. This method has prevailed, especially in oncofertility patients. Although the success rate of the clinical outcomes remains low, this approach, in conjugation with proper counselling, might provide oncofertility patients with an opportunity to preserve their reproductive potential.
通过配子玻璃化冷冻保存生育能力已成为确保癌症患者或面临不孕风险患者生育潜力的关键策略之一。保存配子可防止癌症药物或放疗对配子质量产生有害影响。此外，玻璃化冷冻的成熟人类卵母细胞受精最近已显示出有希望的结果，体现在解冻卵母细胞的存活率提高以及由此产生的临床妊娠率上。然而，癌症患者成熟卵母细胞冷冻保存仍存在局限性。包含使用促性腺激素释放激素的卵巢刺激方案可能会加重癌症病情或延误必要的癌症治疗。考虑到这种情况，未成熟卵母细胞的玻璃化冷冻将成为一种合理的选择。虽然成熟卵母细胞的玻璃化冷冻程序已经确立，但未成熟卵母细胞的玻璃化冷冻仍存在争议，因为解冻后的成熟和受精率较低。在人类和动物模型卵母细胞中均观察到解冻或复温后未成熟卵母细胞明显的冷冻损伤。因此，有人提出了一种替代策略，即在玻璃化冷冻之前先进行卵母细胞成熟过程，以提高利用未成熟卵母细胞进行生育力保存的有效性。这种方法已很普遍，尤其是在肿瘤生育患者中。尽管临床结果的成功率仍然较低，但这种方法结合适当的咨询，可能会为肿瘤生育患者提供一个保留其生殖潜力的机会。
