Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Kanagawa, 216-8511, Japan.
J Assist Reprod Genet. 2023 Dec;40(12):2787-2797. doi: 10.1007/s10815-023-02958-x. Epub 2023 Oct 2.
Although recent in vitro maturation (IVM) studies in pediatric patients have demonstrated successful retrieval and maturation of oocytes, the studies included only a small number of premenarchal patients. In the present study, we examined the potential use of oocyte retrieval and maturation for pediatric patients who undergo ovarian tissue cryopreservation (OTC).
We retrospectively examined the clinical records of pediatric patients who underwent OTC at our institution between October 2015 and December 2022. Data on the age, primary disease, menstrual history, pre-procedure chemotherapy, anti-Müllerian hormone (AMH) level, number of oocytes collected ex vivo from ovarian tissue, and number of mature oocytes from IVM were examined.
Data of 60 pediatric patients (aged 1 to 17 years) were included for analysis. Oocytes were retrieved from 36 patients; the oocytes of 18 of these patients could be cryopreserved. The IVM rate was significantly lower in the premenarchal patients than in the postmenarchal patients. The number of mature oocytes retrieved from IVM was higher in the no-chemotherapy group than in the chemotherapy group. A significant positive correlation was observed between the AMH level and the IVM outcomes.
Oocyte retrieval and maturation in pediatric patients undergoing OTC is particularly useful in those not receiving chemotherapy. In patients receiving chemotherapy, the AMH level may be useful for predicting the IVM outcome. Activation of the oocyte maturation process in vivo in pediatric patients and better understanding of the major regulators of oocyte maturation are necessary to improve the utility of the IVM procedure.
尽管最近的儿科患者体外成熟(IVM)研究已经证明了卵母细胞的成功获取和成熟,但这些研究仅包括少数青春期前患者。在本研究中,我们研究了接受卵巢组织冷冻保存(OTC)的儿科患者卵母细胞获取和成熟的潜在用途。
我们回顾性检查了 2015 年 10 月至 2022 年 12 月期间在我们机构接受 OTC 的儿科患者的临床记录。检查的数据包括年龄、主要疾病、月经史、术前化疗、抗苗勒管激素(AMH)水平、从卵巢组织体外采集的卵母细胞数量以及 IVM 中成熟卵母细胞的数量。
纳入了 60 名儿科患者(年龄 1 至 17 岁)的数据进行分析。从 36 名患者中获取卵母细胞,其中 18 名患者的卵母细胞可以冷冻保存。青春期前患者的 IVM 率明显低于青春期后患者。未化疗组从 IVM 中获取的成熟卵母细胞数量高于化疗组。AMH 水平与 IVM 结果呈显著正相关。
在接受 OTC 的儿科患者中进行卵母细胞获取和成熟对于未接受化疗的患者特别有用。在接受化疗的患者中,AMH 水平可能有助于预测 IVM 结果。为了提高 IVM 程序的实用性,有必要在儿科患者体内激活卵母细胞成熟过程,并更好地了解卵母细胞成熟的主要调节因子。