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与妇科开腹手术中进行生育力保存的卵母细胞取出术成功相关的因素。

Factors associated with successful intraoperative oocyte retrieval for fertility preservation during open pelvic surgery for gynecologic indications.

机构信息

Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea.

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

出版信息

Eur J Obstet Gynecol Reprod Biol. 2024 Oct;301:43-48. doi: 10.1016/j.ejogrb.2024.07.055. Epub 2024 Jul 26.

Abstract

OBJECTIVE

The study investigated factors associated with successful intra-operative oocyte retrieval for fertility preservation during transabdominal gynecologic surgery.

STUDY DESIGN

A total of 29 patients who underwent intraoperative oocyte retrieval during staging surgery at a single academic hospital from May 2014 to August 2022 were enrolled in this study, and their outcomes were analyzed.

RESULTS

Among 29 patients who underwent intra-operative oocyte retrieval during staging surgery, oocytes were obtained in 24 patients, representing 82.8 % of the retrieval rate (24/29), and two patients returned to use cryopreserved oocytes (6.9 %). Among 24 women who succeeded in obtaining oocytes, 20 patients succeeded in oocyte cryopreservation, and two patients proceeded to embryo cryopreservation. The cryopreservation rate was 91.7 % (22/24). All patients with failed oocyte retrieval (n = 5) and cryopreservation (n = 7) were diagnosed with malignancy. AMH of those with successful cryopreservation oocytes was higher than those without cryopreservation (4.10 ng/mL vs. 1.18 ng/mL, p = 0.003). A higher portion of the unstimulated cycle was observed in those with failed cryopreservation (8.3 % vs. 40.0 %, p = 0.01). No complications were noted.

CONCLUSION

For women planning to undergo open pelvic surgery, intra-operative oocyte retrieval is a feasible option. High serum AMH and ovarian stimulation before surgery may predict successful oocyte cryopreservation.

摘要

目的

本研究旨在探讨经腹妇科手术中行术中卵母细胞取卵以进行生育力保存时与取卵成功相关的因素。

研究设计

本研究纳入了 2014 年 5 月至 2022 年 8 月期间在一家学术医院行分期手术期间行术中卵母细胞取卵的 29 例患者,并对其结局进行了分析。

结果

在 29 例行分期手术术中卵母细胞取卵的患者中,有 24 例患者获得了卵母细胞,取卵率为 82.8%(24/29),其中 2 例患者返回使用了冷冻保存的卵母细胞(6.9%)。在 24 例成功获得卵母细胞的女性中,有 20 例成功进行了卵母细胞冷冻保存,有 2 例患者进行了胚胎冷冻保存。冷冻保存率为 91.7%(22/24)。所有取卵失败(n=5)和冷冻保存失败(n=7)的患者均诊断为恶性肿瘤。成功冷冻保存卵母细胞的患者的 AMH 高于未冷冻保存的患者(4.10ng/mL 比 1.18ng/mL,p=0.003)。冷冻保存失败的患者中未刺激周期的比例更高(8.3%比 40.0%,p=0.01)。未观察到并发症。

结论

对于计划行开腹盆腔手术的女性,术中卵母细胞取卵是一种可行的选择。术前血清 AMH 水平较高且卵巢刺激可能预测卵母细胞的成功冷冻保存。

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