New advances in ovarian autotransplantation to restore fertility in cancer patients.
New advances in ovarian autotransplantation to restore fertility in cancer patients.
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DOI：
10.1007/s10555-015-9600-2
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发表时间：
2015-12
期刊：
影响因子：
--
通讯作者：
Woodruff TK
中科院分区：
文献类型：
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作者：
Salama M;Woodruff TK
人类卵巢自体移植是一个有前途的选择生育能力的年轻妇女和女孩接受性腺毒性治疗癌症或一些自身免疫性疾病。虽然是实验性的，但它在全世界至少产生了42个健康的婴儿。根据系统性综述和荟萃分析首选报告项目（PRISMA）指南，对PubMed 2000年1月1日至2015年10月1日期间发表的所有相关英文全文文献进行系统性文献综述，以探讨人类卵巢自体移植的最新临床和研究进展。人类卵巢自体移植包括卵巢组织提取、冷冻/解冻和移植回同一患者体内。存在三种主要形式的人卵巢自体移植，包括（a）皮质卵巢组织的移植，（B）整个卵巢的移植，和（c）卵巢卵泡（人工卵巢）的移植。根据最近的指南，人类卵巢自体移植仍然被认为是实验性的;然而，与其他女性生育能力保留方案相比，它具有独特的优势。人类卵巢自体移植（i）不需要事先卵巢刺激，（ii）允许立即开始癌症治疗，（iii）可以恢复内分泌和生殖卵巢功能，（iv）可能是唯一适合青春期前女孩或患有雌激素敏感性恶性肿瘤的年轻女性的生育保留选择。与任何其他生育力保存选择一样，人类卵巢自体移植既有优点也有缺点，可能并不适用于所有病例。这种选择面临的主要挑战是如何避免再次引入恶性细胞的风险，如何延长卵巢移植的寿命以及如何改善人工卵巢的结果。
Human ovary autotransplantation is a promising option for fertility preservation of young women and girls undergoing gonadotoxic treatments for cancer or some autoimmune diseases. Although experimental, it resulted in at least 42 healthy babies worldwide. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic literature review was performed for all relevant full-text articles published in English from 1 January 2000 to 01 October 2015 in PubMed to explore the latest clinical and research advances of human ovary autotransplantation. Human ovary autotransplantation involves ovarian tissue extraction, freezing/thawing, and transplantation back into the same patient. Three major forms of human ovary autotransplantation exist including (a) transplantation of cortical ovarian tissue, (b) transplantation of whole ovary, and (c) transplantation of ovarian follicles (artificial ovary). According to the recent guidelines, human ovary autotransplantation is still considered experimental; however, it has unique advantages in comparison to other options of female fertility preservation. Human ovary autotransplantation (i) does not need prior ovarian stimulation, (ii) allows immediate initiation of cancer therapy, (iii) can restore both endocrine and reproductive ovarian functions, and (iv) may be the only fertility preservation option suitable for prepubertal girls or for young women with estrogen-sensitive malignancies. As any other fertility preservation option, human ovary autotransplantation has both advantages and disadvantages and may not be feasible for all cases. The major challenges facing this option are how to avoid the risk of reintroducing malignant cells and how to prolong the lifespan of ovarian transplant as well as how to improve artificial ovary results.