Utility and Outcomes of Ovarian Tissue Cryopreservation and Transplantation for Gynecologic Cancers: A Systematic Review and Meta-analysis.

IF 5.7 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Obstetrics and gynecology Pub Date : 2024-10-01 Epub Date: 2024-08-22 DOI:10.1097/AOG.0000000000005708
Murat Erden, Sonia Gayete-Lafuente, Nazli Aylin Vural, Kutluk H Oktay
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引用次数: 0

Abstract

Objective: To evaluate the utility, success, and safety of ovarian tissue cryopreservation and autologous cryopreserved ovarian tissue transplantation for fertility preservation in patients with gynecologic cancers.

Data sources: A comprehensive search was performed of the MEDLINE, EMBASE, ClinicalTrials.gov , and Cochrane Library databases to identify relevant studies on the utility and outcomes of ovarian tissue cryopreservation and autologous cryopreserved ovarian tissue transplantation for gynecologic cancers from inception until January 23, 2024.

Methods of study selection: Two reviewers independently performed the study selection, data extraction, and risk-of-bias assessment, and the results were then reviewed together. Twenty-three studies were included in the current systematic review.

Tabulation, integration, and results: The resultant data were meta-analyzed to produce a pooled-effect estimate of the utility of ovarian tissue cryopreservation and autologous transplantation in gynecologic cancers as a proportion of all indications. We found that 7.5% and 9.6% of women undergoing ovarian tissue cryopreservation and autologous transplantation, respectively, had gynecologic cancers. In comparison, hematologic malignancies and breast cancer accounted for approximately 66.0% of all indications for these procedures. The return rate for autologous cryopreserved ovarian tissue transplantation in gynecologic cancers (6.0%) was not statistically different from those for other indications. Among women with gynecologic cancer who underwent ovarian stimulation, 27.3% had at least one child, and the ovarian endocrine function was restored in 78.1% of the women after autologous transplantation. The median graft longevity was 32 months, and no graft-site recurrence was reported after autologous transplantation in women with gynecologic cancer.

Conclusion: Our results suggest that ovarian tissue cryopreservation and autologous transplantation are feasible options for preserving ovarian function in women with gynecologic cancers, although ovarian tissue cryopreservation is underutilized, and further studies are needed to determine the longer-term outcomes of autologous transplantation.

Systematic review registration: PROSPERO, CRD42024498522.

卵巢组织冷冻保存和移植治疗妇科癌症的效用和结果:系统回顾与元分析》。
目的评估卵巢组织冷冻保存和自体冷冻保存卵巢组织移植用于妇科癌症患者生育力保存的实用性、成功率和安全性:对 MEDLINE、EMBASE、ClinicalTrials.gov 和 Cochrane Library 数据库进行了全面检索,以确定从开始到 2024 年 1 月 23 日期间有关卵巢组织冷冻保存和自体冷冻保存卵巢组织移植治疗妇科癌症的效用和结果的相关研究:两位审稿人分别独立完成了研究筛选、数据提取和偏倚风险评估工作,然后共同对结果进行了审阅。本次系统综述共纳入 23 项研究:对所得数据进行荟萃分析,得出卵巢组织冷冻保存和自体移植在妇科癌症中的效用在所有适应症中所占比例的集合效应估计值。我们发现,在接受卵巢组织冷冻保存和自体移植的妇女中,分别有 7.5% 和 9.6% 患有妇科癌症。相比之下,血液系统恶性肿瘤和乳腺癌约占这些手术所有适应症的 66.0%。妇科癌症自体冷冻保存卵巢组织移植的返还率(6.0%)与其他适应症的返还率没有统计学差异。在接受卵巢刺激的妇科癌症妇女中,27.3%至少生育了一个孩子,78.1%的妇女在自体移植后恢复了卵巢内分泌功能。中位移植寿命为32个月,妇科癌症妇女自体移植后没有移植部位复发的报道:我们的研究结果表明,卵巢组织冷冻保存和自体移植是保留妇科癌症妇女卵巢功能的可行方案,尽管卵巢组织冷冻保存的利用率较低,还需要进一步研究以确定自体移植的长期效果:prospero,CRD42024498522。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Obstetrics and gynecology
Obstetrics and gynecology 医学-妇产科学
CiteScore
11.10
自引率
4.20%
发文量
867
审稿时长
1 months
期刊介绍: "Obstetrics & Gynecology," affectionately known as "The Green Journal," is the official publication of the American College of Obstetricians and Gynecologists (ACOG). Since its inception in 1953, the journal has been dedicated to advancing the clinical practice of obstetrics and gynecology, as well as related fields. The journal's mission is to promote excellence in these areas by publishing a diverse range of articles that cover translational and clinical topics. "Obstetrics & Gynecology" provides a platform for the dissemination of evidence-based research, clinical guidelines, and expert opinions that are essential for the continuous improvement of women's health care. The journal's content is designed to inform and educate obstetricians, gynecologists, and other healthcare professionals, ensuring that they stay abreast of the latest developments and best practices in their field.
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