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接受卵巢组织冻存的年轻女性的经验和妇科及生殖健康随访。

Experience, and gynaecological and reproductive health follow-up of young adult women who have undergone ovarian tissue cryopreservation.

机构信息

Normandie University, UNIROUEN, EA 4308 'Gametogenesis and Gamete Quality', Rouen University Hospital, Biology of Reproduction-CECOS Laboratory, Rouen 76031, France; Rouen University Hospital, Department of Gynecology and Obstetrics, Rouen 76031, France.

Normandie University, UNIROUEN, EA 4308 'Gametogenesis and Gamete Quality', Rouen University Hospital, Biology of Reproduction-CECOS Laboratory, Rouen 76031, France.

出版信息

Reprod Biomed Online. 2022 Nov;45(5):913-922. doi: 10.1016/j.rbmo.2022.06.016. Epub 2022 Jun 23.

Abstract

RESEARCH QUESTION

What are the experience, and gynaecological and reproductive health outcomes in young adult women who have undergone ovarian tissue cryopreservation (OTC)?

DESIGN

A retrospective observational study was conducted at a single institution between May 2019 and February 2021 including 87 women aged over 18 years undergoing OTC. Medical characteristics and questionnaire data collected more than 18 months after OTC were analysed.

RESULTS

Close to 74% (n = 64/87) of women had a follow-up consultation and completed the questionnaire. Most women found the information provided on the OTC technique and the strategies proposed to restore fertility with ovarian tissue understandable and useful. The majority of patients thought that OTC had a positive impact on their well-being during disease treatment. Anti-Müllerian hormone serum concentration decreased significantly after treatment (P < 0.0001) and was significantly lower when patients received chemotherapy before OTC (P = 0.0039). The total cyclophosphamide equivalent dose was significantly higher in women with FSH concentrations above 25 IU/l after treatment (P = 0.0004). More than 70% of women who planned a pregnancy after the end of treatment succeeded, with a natural pregnancy rate close to 53%. Only nine patients (8.0%) underwent ovarian tissue transplantation for fertility restoration and six of them became pregnant and delivered at least once.

CONCLUSION

Young adult women expressed a good satisfaction rate with OTC and that their experience had been beneficial. The usage rate of cryopreserved ovarian tissue remains low. The gynaecological and reproductive health follow-up consultation should be included in the supportive care provided following OTC.

摘要

研究问题

接受卵巢组织冷冻保存(OTC)的年轻成年女性的经验,以及她们的妇科和生殖健康结局如何?

设计

这是一项回顾性观察研究,在 2019 年 5 月至 2021 年 2 月期间在一家机构进行,纳入了 87 名年龄超过 18 岁接受 OTC 的女性。分析了 OTC 后 18 个月以上收集的医学特征和问卷调查数据。

结果

近 74%(n=64/87)的女性进行了随访咨询并完成了问卷调查。大多数女性认为提供的 OTC 技术信息和提出的恢复卵巢组织生育力的策略是可以理解和有用的。大多数患者认为 OTC 在疾病治疗期间对其健康状况有积极影响。治疗后血清抗苗勒管激素浓度显著下降(P<0.0001),且在 OTC 前接受化疗的患者中显著降低(P=0.0039)。治疗后 FSH 浓度高于 25 IU/l 的女性的总环磷酰胺等效剂量显著升高(P=0.0004)。超过 70%的计划在治疗结束后怀孕的女性成功妊娠,其自然妊娠率接近 53%。只有 9 名患者(8.0%)为了恢复生育力而进行了卵巢组织移植,其中 6 名患者成功怀孕并至少分娩一次。

结论

年轻成年女性对 OTC 的满意度高,认为她们的经历是有益的。冷冻保存的卵巢组织的使用率仍然较低。应将卵巢组织冷冻保存后的妇科和生殖健康随访咨询纳入支持性护理中。

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