Abstract：
Individuals with a disease or treatment that will increase their risk of premature gonadal insufficiency may opt to undergo fertility preservation. Those who are post-pubertal can often cryopreserve gametes, sperm or eggs, to expand their biological family using assisted reproductive technologies. Ovarian tissue cryopreservation (OTC) and testicular tissue cryopreservation may be an option for individuals who are unable to utilize standard fertility preservation techniques. The development of OTC was critical for many patients, including prepubertal children with ovaries that do not yet produce eggs, adolescents who make few good quality eggs and adult women with ovaries who cannot undergo ovarian stimulation. The only option to restore fertility and hormone production following OTC is through ovarian tissue transplantation (OTT). OTC and OTT have been successful for some patients. While OTC is no longer considered experimental by the American Society of Reproductive Medicine, the process is far from standardized. Significant research needs to be done, especially at the point of OTT, to improve the success and longevity of the ovarian tissue function. This article lists the main steps from surgical procurement of the ovarian tissue to transplantation and restoration of function. Our pediatric hospital program has had to decide which options in procurement, processing, cryopreservation and warming will be used in our clinical lab. The options and limitations within the research and analyses are briefly discussed. Literature focusing on techniques to improve OTT effectiveness and longevity was reviewed. OTT studies that performed xenograft experiments after pretreatment of the tissue graft by a ligand or drug, treatment of host, or encapsulation of the ovarian tissue were identified. The intended effects of the treatments include increasing vascularization, reducing apoptosis and directing activation or suppression of primordial follicles. Robust research in this area must continue with rigorous analyses to make strides for improving fertility preservation and restoration options for patients.
摘要：
患有疾病或治疗会增加其过早性腺功能不全风险的个体可以选择进行生育能力保存。青春期后的人通常可以冷冻保存配子，精子或卵子，使用辅助生殖技术扩大他们的生物家庭。卵巢组织冷冻保存（OTC）和睾丸组织冷冻保存可能是无法使用标准生育力保存技术的个体的一种选择。OTC的发展对许多患者来说至关重要，包括卵巢尚未产卵的青春期前儿童，少产优质卵子的青少年和卵巢不能接受卵巢刺激的成年女性。OTC后恢复生育力和激素产生的唯一选择是通过卵巢组织移植（OTT）。OTC和OTT对于一些患者已经成功。虽然美国生殖医学学会不再认为OTC是实验性的，这个过程远非标准化。需要做大量的研究，尤其是在OTT的时候，提高成功和长寿的卵巢组织功能。本文列出了从手术购买卵巢组织到移植和恢复功能的主要步骤。我们的儿科医院计划不得不决定采购中的哪些选择，processing,冷冻保存和加温将用于我们的临床实验室。简要讨论了研究和分析中的选择和局限性。综述了有关提高OTT有效性和寿命的技术的文献。用配体或药物预处理组织移植物后进行异种移植实验的OTT研究，宿主的治疗，或卵巢组织的包囊被鉴定。治疗的预期效果包括增加血管形成，减少细胞凋亡和指导激活或抑制原始卵泡。该领域的稳健研究必须继续进行严格的分析，以在改善患者的生育能力保护和恢复选择方面取得进展。
