PDF(Pubmed)
Abstract：
Ovarian transposition (OT) has been proposed as a protective measure against radiation-induced damage to ovarian function and fertility. Despite its historical use, limited research has focused on evaluating endocrine and exocrine ovarian function after OT performed in adolescents and young adults (AYAs) before or during puberty. The purpose of our study was to investigate the fertility, pubertal development, and ovarian function of women with a previous history of OT during childhood, adolescence or young adulthood. In an observational bicentric retrospective study, we included 32 young female cancer patients who underwent OT before the age of 26 between 1990 and 2015 at Lyon Léon Bérard Cancer Center or Nancy University Hospital. The mean age at the time of OT was 15.6 years with a cancer diagnosis at 15 ± 4.8 years. Among the 10 women attempting pregnancy post-treatment, 60% achieved successful pregnancies. After a mean follow-up of 9.6 ± 7 years, 74% (17 out of 23) of women recovered spontaneous menstrual cycles (seven out of eight evaluable women with OT before or during puberty). Notably, 35% of women who did not attempt pregnancy demonstrated adequate ovarian reserve. Ovarian reserve and function recovery were influenced by the specific chemotherapy received. Importantly, our findings suggest that OT\'s effectiveness on ovarian activity resumption does not significantly differ when performed before or during puberty compared to pubertal stages. This study contributes valuable insights into the long-term reproductive outcomes of young women undergoing OT, emphasizing its potential efficacy in preserving ovarian function and fertility across different developmental stages.
摘要：
已提出卵巢移位术（OT）作为针对辐射引起的卵巢功能和生育能力损害的保护措施。尽管它的历史用途，有限的研究集中在评估青春期之前或青春期期间在青少年和年轻人（AYAs）中进行OT后的内分泌和外分泌卵巢功能。我们研究的目的是调查生育率，青春期发育,和卵巢功能的女性在童年时期有OT的历史，青春期或年轻的成年。在一项观察性的双中心回顾性研究中，我们纳入了32例于1990年至2015年间在里昂贝拉德癌症中心或南希大学医院26岁之前接受了OT的年轻女性癌症患者.OT时的平均年龄为15.6岁，癌症诊断为15±4.8岁。在治疗后尝试怀孕的10名妇女中，60%成功怀孕。经过9.6±7年的平均随访，74％（23人中有17人）的女性恢复了自发的月经周期（8名可评估的女性中有7名在青春期之前或青春期期间患有OT）。值得注意的是,35%未尝试怀孕的妇女表现出足够的卵巢储备。接受的特定化疗会影响卵巢储备和功能恢复。重要的是,我们的研究结果表明,与青春期阶段相比,在青春期之前或期间进行OT对卵巢活动恢复的有效性没有显著差异.这项研究为接受OT的年轻女性的长期生殖结果提供了宝贵的见解，强调其在不同发育阶段保留卵巢功能和生育能力的潜在功效。
