Operative techniques and complications of extraction and transplantation of ovarian tissue: the Erlangen experience
Operative techniques and complications of extraction and transplantation of ovarian tissue: the Erlangen experience
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DOI：
10.1007/s00404-017-4311-2
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发表时间：
2017-04-01
影响因子：
2.6
通讯作者：
Mueller, Andreas
中科院分区：
文献类型：
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作者：
Beckmann, Matthia W.;Dittrich, Ralf;Mueller, Andreas
目的在肿瘤治疗前提取卵巢组织并在治疗后移植卵巢组织已越来越多地用于保留妇女的生育能力。本研究描述了标准化和安全的手术程序，并发症少，并报告了由此产生的卵巢功能和妊娠率。方法在Erlangen中心使用的卵巢组织切除和移植的标准化手术技术是：组织切除时，用剪刀从一个卵巢切除三分之一到一半的组织，不进行组织凝固；在随后的移植中，卵巢组织块被放置在腹膜后口袋中，不关闭口袋。结果在2007年1月至2015年12月期间，399名妇女卵巢组织被提取，38名妇女在接受癌症治疗后进行了移植。28天内无手术并发症。迄今为止，在7名不同的妇女中，移植后有10次怀孕和9次活产；38名女性中有26名出现了荷尔蒙活动，经月经周期或血清雌二醇水平升高证实。结论腹腔镜卵巢组织切除和移植技术提供了一种标准化的方法，并发症风险极低。卵巢组织移植后的妊娠率目前为15-30%，预计在不久的将来会进一步上升。
Purpose Extracting ovarian tissue before oncologic therapy and transplanting it afterwards are increasingly being used to preserve fertility in women. This study describes standardized and safe operative procedures, with few complications, and reports the resulting ovarian function and pregnancy rates.Methods The standardized operative techniques for removing and transplanting ovarian tissue used at the Erlangen center are: for tissue removal, one-third to half of the tissue from one ovary is excised with scissors, without tissue coagulation; for subsequent transplantation, pieces of ovarian tissue are placed in a retroperitoneal pocket without closure of the pocket.Results Between January 2007 and December 2015, ovarian tissue was extracted in 399 women and transplanted following cancer therapy in 38. No surgical complications were observed within 28 days. To date, there have been ten pregnancies and nine live births after transplantation in seven different women; 26 of the 38 women developed hormonal activity, confirmed by a menstrual cycle or raised serum estradiol levels.Conclusions The techniques for laparoscopic removal and transplantation of ovarian tissue described here provide a standardized method with a very low risk of complications. The pregnancy rate after ovarian tissue transplantation, currently 15-30%, can be expected to rise further in the near future.