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韩国一家三级医疗中心的生育力保存经验。

The Experience of Fertility Preservation in a Single Tertiary Center in Korea.

机构信息

Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, South Korea.

Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, South Korea.

出版信息

Front Endocrinol (Lausanne). 2022 Apr 19;13:845051. doi: 10.3389/fendo.2022.845051. eCollection 2022.

Abstract

OBJECTIVE

Oocyte (OC), embryo (EC), and ovarian tissue cryopreservation (OTC) are options for fertility preservation (FP) before going through gonadotoxic cancer treatment, or anticipated fertility decline in benign ovarian diseases, or for planned OC. The aim of this study is to report outcomes of FP in a single tertiary hospital in Korea.

METHODS

This is a retrospective study of OC, EC, and OTC cycles. All patients who visited or were referred to the infertility clinic at the Department of Obstetrics and Gynecology for the purpose of FP between 2010 and October 2021 were included.

RESULTS

A total of 564 controlled ovarian stimulation cycles were conducted in 416 women. Three hundred fifty-seven women underwent 494 OC cycles. Most patients were diagnosed with breast cancer (22.4%), followed by endometriomas (21.9%), and then by planned OC (20.7%). Cases of OC have increased over the years, peaking at 109 cycles in 2019 compared to one in 2010. Fifty-nine women underwent 70 EC cycles, and breast cancer (50.8%) was the most common indication. Repetitive OC and EC cycles were undergone in 92 and 9 women, respectively (mean number of repetition, 1.37 and 1.19 times in OC and EC, respectively), yielding a maximum number of 33 oocytes or 23 embryos being cryopreserved per patient. The utilization rate was 3.1% (11/357) in OC and 16.9% (10/59) in EC. Twenty-six women underwent OTC, and gynecologic cancer was the most common indication (9/26, 34.6%). One woman had the cryopreserved ovarian tissue retransplanted and successfully generated embryos.

CONCLUSION

OC, EC, and OTC are possible options for preserving fertility, and these opportunities should be provided for women at risk of fertility decline or those who are eager to protect their future fertility. This is the first report on long-term FP outcomes in a single tertiary center in Korea. We expect that there will be more cases over the years and more women returning to use their gametes or embryos for pregnancy.

摘要

目的

卵子(OC)、胚胎(EC)和卵巢组织冷冻保存(OTC)是接受性腺毒性癌症治疗前或良性卵巢疾病预期生育能力下降或计划 OC 时进行生育力保存(FP)的选择。本研究旨在报告韩国一家三级医院的 FP 结果。

方法

这是一项回顾性研究,涉及 OC、EC 和 OTC 周期。所有于 2010 年至 2021 年 10 月期间因 FP 目的前往妇产科不孕症诊所就诊或转介至该诊所的患者均被纳入研究。

结果

在 416 名女性中进行了 564 个控制性卵巢刺激周期。357 名女性接受了 494 个 OC 周期。大多数患者被诊断为乳腺癌(22.4%),其次是子宫内膜异位症(21.9%),然后是计划 OC(20.7%)。OC 案例数量逐年增加,2019 年达到 109 个周期,而 2010 年仅为 1 个周期。59 名女性接受了 70 个 EC 周期,最常见的指征是乳腺癌(50.8%)。92 名和 9 名女性分别重复进行了 OC 和 EC 周期(OC 和 EC 的重复次数平均分别为 1.37 次和 1.19 次),每个患者最多可冷冻保存 33 个卵子或 23 个胚胎。OC 的利用率为 3.1%(11/357),EC 的利用率为 16.9%(10/59)。26 名女性接受了 OTC,妇科癌症是最常见的指征(26 例中的 9 例,34.6%)。一名女性将冷冻保存的卵巢组织重新移植并成功生成胚胎。

结论

OC、EC 和 OTC 是保存生育能力的可行选择,应向有生育能力下降风险或急于保护未来生育能力的女性提供这些机会。这是韩国一家三级中心关于长期 FP 结果的首次报告。我们预计,未来几年内会有更多的案例,并且会有更多的女性返回使用她们的配子或胚胎来怀孕。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/16dd/9062070/5966feee1da3/fendo-13-845051-g001.jpg

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