Fertility preservation in girls during childhood: is it feasible, efficient and safe and to whom should it be proposed?
Fertility preservation in girls during childhood: is it feasible, efficient and safe and to whom should it be proposed?
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DOI：
10.1093/humupd/dmq010
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发表时间：
2010-11-01
影响因子：
13.3
通讯作者：
Donnez, Jacques
中科院分区：
文献类型：
--
作者：
Jadoul, Pascale;Dolmans, Marie-Madeleine;Donnez, Jacques
在青春期前和青春期女孩中，生殖能力可能会因性腺毒性治疗、重复卵巢手术或遗传疾病而受损。冷冻保存卵巢皮质是一种现有的选择，以保持这些年轻女孩的生育能力，在卵巢早衰（POF）的风险。为了验证该技术，必须评估儿童卵巢冷冻保存的有效性、可行性和风险，在此，我们使用PubMed数据库对成人卵巢冷冻保存进行了回顾，更具体地说，是对儿童卵巢冷冻保存进行了回顾。此外，我们对自己在儿童卵巢冷冻保存方面的经验进行了评估，并与文献进行了比较，对文献和6个已发表的儿童卵巢冷冻保存系列以及我们自己的58例系列的分析表明，没有理由怀疑其在这一年轻人群中的疗效。然而，尚未就该技术的适应症达成共识。事实上，在现有的模型中，卵巢早衰的真实的风险可能被高估或低估。我们的综述表明，卵巢皮质冷冻保存是可行的，并且与儿童手术一样安全。虽然还没有出生导致冻融的青春期前卵巢皮质，这种方法在成年人中的结果是令人鼓舞的。然而，在与有POF风险的女孩及其父母讨论生育问题时，应考虑到对生育力保存的适应症以及冷冻保存卵巢皮质的最佳时间和数量缺乏共识。
In prepubertal and adolescent girls, fertility may be impaired by gonadotoxic treatments, repeat ovarian surgery or genetic disorders. Cryopreservation of ovarian cortex is an existing option to preserve fertility in these young girls at risk of premature ovarian failure (POF). The efficacy, feasibility and risks of ovarian cryopreservation in children must be assessed in order to validate the technique.Here, we conducted a review of ovarian cryopreservation in adults and, more specifically, in children using the PubMed databases. In addition, our own experience with ovarian cryopreservation in children was evaluated and compared with the literature.Analysis of the literature and six published series on ovarian cryopreservation in children, as well as our own series of 58 cases, show that there is no reason to doubt its efficacy in this young population. However, no consensus has yet been reached on the indications for the technique. Indeed, with existing models, the real risk of POF may be over- or underestimated.Our review suggests that ovarian cortex cryopreservation is feasible and as safe as comparable operative procedures in children. Although no births have yet resulted from freeze-thawing of prepubertal ovarian cortex, the results of this approach in adults are encouraging. However, the absence of consensus on the indications for fertility preservation, as well as the optimal timing and quantity of ovarian cortex for cryopreservation, should be taken into consideration when discussing fertility issues with girls at risk of POF and their parents.