分析剔除子宫内膜异位瘤后所附着卵巢皮质组织中（窦状）卵泡密度。
Histological analysis of (antral) follicle density in ovarian cortex tissue attached to stripped endometriomas.
机构信息
Department of Gynaecology and Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands.
Endometriose Centrum, Haaglanden Medical Centre, Den Haag, The Netherlands.
出版信息
J Assist Reprod Genet. 2024 Apr;41(4):1067-1076. doi: 10.1007/s10815-024-03058-0. Epub 2024 Mar 5.
PURPOSE
When resecting endometriomas with the stripping technique, in the majority of cases, a thin line of adjacent ovarian cortex is attached to the endometrioma. In this study, we performed histological analysis to determine (antral) follicle density in the ovarian cortex tissue attached to stripped endometriomas and assessed patient- and surgical characteristics that could affect this.
METHODS
Histological slides of previously removed endometriomas were assessed. Follicles in the attached ovarian tissue were classified according to maturation, and follicular density was determined. Immunofluorescent staining of antral follicles in a subset of endometriomas was also performed.
RESULTS
In 90 out of 96 included endometriomas (93.7%), ovarian tissue attached to the cyst wall was observed. One thousand nine hundred forty-four follicles at different maturation stages were identified (3 follicles/mm). Follicle density was negatively associated with age (p < 0.001). Antral follicles (< 7-mm diameter) were present in the ovarian tissue attached to 35 endometriomas (36.5%) derived from younger patients compared to endometriomas where none were detected (30 versus 35 years, p = 0.003). Antral follicle density was 1 follicle/mm. Based on immunofluorescence, healthy antral follicles were identified in two out of four examined endometriomas.
CONCLUSIONS
Ovarian tissue attached to stripped endometriomas holds potential as a non-invasive source for antral follicles. In theory, application of IVM could be an interesting alternative FP option in young patients with endometriomas who undergo cystectomy in order to transform the surgical collateral damage to a potential oocyte source. Our results encourage future research with fresh tissue to further assess the quality and potential of these follicles.
TRIAL REGISTRATION
Clinical Trials.gov Identifier: B21.055 (METC LDD), date of registration 12-08-2021, retrospectively registered.
目的
在采用剥除术切除子宫内膜异位囊肿时，大多数情况下，囊肿壁与相邻的卵巢皮质之间存在一薄层组织相连。本研究通过组织学分析，旨在评估与剥除的子宫内膜异位囊肿相连的卵巢皮质组织中（窦状）卵泡的密度，并探讨可能影响这一密度的患者和手术特征。
方法
对先前切除的子宫内膜异位囊肿的组织学切片进行评估。将附着卵巢组织中的卵泡按成熟度进行分类，并确定卵泡密度。对一部分子宫内膜异位囊肿中的窦前卵泡进行免疫荧光染色。
结果
在 96 个纳入的子宫内膜异位囊肿中（93.7%），观察到 90 个囊肿壁与卵巢组织相连。共鉴定出 1944 个处于不同成熟阶段的卵泡（3 个/ mm）。卵泡密度与年龄呈负相关（p<0.001）。与未检测到窦前卵泡的囊肿相比（30 岁与 35 岁），在 35 个来自年轻患者的子宫内膜异位囊肿中（<7mm 直径）发现了附着卵巢组织中的窦前卵泡（36.5%）（p=0.003）。窦前卵泡密度为 1 个/ mm。基于免疫荧光，在 4 个检查的子宫内膜异位囊肿中，有 2 个发现了健康的窦前卵泡。
结论
从剥除的子宫内膜异位囊肿附着的卵巢组织中可以作为窦前卵泡的非侵入性来源。理论上，对于因囊肿切除术而导致手术损伤的年轻子宫内膜异位症患者，应用 IVM 可能是一种有前途的 FP 选择，将手术的附带损伤转化为潜在的卵母细胞来源。我们的研究结果鼓励未来使用新鲜组织进行进一步研究，以评估这些卵泡的质量和潜力。
试验注册
临床试验.gov 标识符：B21.055（METC LDD），注册日期为 2021 年 8 月 12 日，为回顾性注册。
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