PDF(Pubmed)
Abstract：
UNASSIGNED: The efficiency of ovarian tissue transplantation (OTT) was established in terms of ovarian function recovery (95% of cases), number of live births (over 200 worldwide to date) and induction of puberty. Unfortunately, the lack of international registries and the fact that many centers have not yet reported their outcomes, lead to poor knowledge of the exact fertility data. The aim of the study is to describe our experience with OTT to restore ovarian function and fertility.
UNASSIGNED: This study was designed as a single-center, observational, retrospective, cohort study that includes women who underwent OTT between December 2012 and June 2023 at our center. After approval by the oncologist/hematologist, a small fragment of ovarian tissue was thawed and analyzed to detect the presence of micrometastases before OTT. Thawed ovarian tissue was grafted laparoscopically at multiple sites, including the remaining ovary and pelvic side wall (orthotopic transplantation) and/or abdominal wall (heterotopic transplantation). After OTT, ovarian function was monitored by hormonal assay, ultrasound and color Doppler at approximately 4-week intervals.
UNASSIGNED: Between December 2012 and June 2023, 30 women performed OTT. Prior to OTT, immunohistochemical and molecular analyses revealed no micrometastases in all thawed ovarian tissue samples. In our series of 30 women, 20 of women were on premature ovarian insufficiency (POI), and the remaining ten cases still had oligomenorrhea and difficulty getting pregnant. Among the women with POI before OTT and at least 6 months follow-up, recovery of endocrine function was observed in all but one woman who underwent orthotopic transplantation (13 of 14 cases), in one out of two women who underwent both orthotopic and heterotopic transplantation (1 of 2 cases) and in all women who underwent heterotopic transplantation (4 of 4 cases). Women who underwent OTT to enhance fertility had no alterations in menstrual cycle and hormonal levels. In total, ten pregnancies were obtained in 25 women, resulting in four live births, two ongoing pregnancies and four spontaneous abortions.
UNASSIGNED: Our data can help patients and physicians in their discussions and decisions about the need and possibilities of preserving fertility.
UNASSIGNED: This study was designed as a single-center, observational, retrospective, cohort study that includes women who underwent OTT between December 2012 and June 2023 at our center. After approval by the oncologist/hematologist, a small fragment of ovarian tissue was thawed and analyzed to detect the presence of micrometastases before OTT. Thawed ovarian tissue was grafted laparoscopically at multiple sites, including the remaining ovary and pelvic side wall (orthotopic transplantation) and/or abdominal wall (heterotopic transplantation). After OTT, ovarian function was monitored by hormonal assay, ultrasound and color Doppler at approximately 4-week intervals.
UNASSIGNED: Between December 2012 and June 2023, 30 women performed OTT. Prior to OTT, immunohistochemical and molecular analyses revealed no micrometastases in all thawed ovarian tissue samples. In our series of 30 women, 20 of women were on premature ovarian insufficiency (POI), and the remaining ten cases still had oligomenorrhea and difficulty getting pregnant. Among the women with POI before OTT and at least 6 months follow-up, recovery of endocrine function was observed in all but one woman who underwent orthotopic transplantation (13 of 14 cases), in one out of two women who underwent both orthotopic and heterotopic transplantation (1 of 2 cases) and in all women who underwent heterotopic transplantation (4 of 4 cases). Women who underwent OTT to enhance fertility had no alterations in menstrual cycle and hormonal levels. In total, ten pregnancies were obtained in 25 women, resulting in four live births, two ongoing pregnancies and four spontaneous abortions.
UNASSIGNED: Our data can help patients and physicians in their discussions and decisions about the need and possibilities of preserving fertility.
摘要：
■卵巢组织移植（OTT）的效率是根据卵巢功能恢复（95％的病例）确定的，活产数量(迄今为止全球超过200个)和青春期诱导。不幸的是,缺乏国际注册管理机构以及许多中心尚未报告其结果的事实，导致对确切生育率数据的了解不足。该研究的目的是描述我们使用OTT恢复卵巢功能和生育能力的经验。
■本研究设计为单中心，观察,回顾性,队列研究，包括2012年12月至2023年6月在我们中心接受OTT的女性。经肿瘤学家/血液学家批准后，在OTT前,我们解冻了一小段卵巢组织,并对其进行了分析,以检测是否存在微转移.解冻的卵巢组织在多个部位进行腹腔镜移植，包括剩余的卵巢和骨盆侧壁（原位移植）和/或腹壁（异位移植）。OTT之后,通过激素检测来监测卵巢功能，超声和彩色多普勒在大约4周的间隔。
■在2012年12月至2023年6月之间，有30名女性进行了OTT。在OTT之前,免疫组织化学和分子分析显示，所有解冻的卵巢组织样本均未发生微转移。在我们的30个女人系列中，20名女性患有卵巢早衰（POI），其余十例仍有月经少发和怀孕困难。在OTT之前和至少6个月随访的POI女性中，除了一名接受原位移植的妇女（14例中有13例）外，所有妇女的内分泌功能均恢复。在接受原位和异位移植的两名妇女中，有一名（2例病例中的1例）和所有接受异位移植的妇女（4例病例中的4例）。接受OTT以提高生育能力的女性月经周期和激素水平没有改变。总的来说,25名妇女怀孕10次，导致四个活产，两次持续怀孕和四次自然流产。
■我们的数据可以帮助患者和医生讨论和决定保留生育能力的必要性和可能性。
■本研究设计为单中心，观察,回顾性,队列研究，包括2012年12月至2023年6月在我们中心接受OTT的女性。经肿瘤学家/血液学家批准后，在OTT前,我们解冻了一小段卵巢组织,并对其进行了分析,以检测是否存在微转移.解冻的卵巢组织在多个部位进行腹腔镜移植，包括剩余的卵巢和骨盆侧壁（原位移植）和/或腹壁（异位移植）。OTT之后,通过激素检测来监测卵巢功能，超声和彩色多普勒在大约4周的间隔。
■在2012年12月至2023年6月之间，有30名女性进行了OTT。在OTT之前,免疫组织化学和分子分析显示，所有解冻的卵巢组织样本均未发生微转移。在我们的30个女人系列中，20名女性患有卵巢早衰（POI），其余十例仍有月经少发和怀孕困难。在OTT之前和至少6个月随访的POI女性中，除了一名接受原位移植的妇女（14例中有13例）外，所有妇女的内分泌功能均恢复。在接受原位和异位移植的两名妇女中，有一名（2例病例中的1例）和所有接受异位移植的妇女（4例病例中的4例）。接受OTT以提高生育能力的女性月经周期和激素水平没有改变。总的来说,25名妇女怀孕10次，导致四个活产，两次持续怀孕和四次自然流产。
■我们的数据可以帮助患者和医生讨论和决定保留生育能力的必要性和可能性。
