中国一名 8 岁女孩造血干细胞移植后的卵巢组织冷冻保存:病例报告和文献综述。

IF 2 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Gynecological Endocrinology Pub Date : 2024-12-01 Epub Date: 2024-11-26 DOI:10.1080/09513590.2024.2431219
Zecheng Wang, Xiangyan Ruan, Juan Du, Fengyu Jin, Muqing Gu, JiaoJiao Cheng, Yanqiu Li, Yanglu Li, Lili Liu, Yurui Wu, Alfred O Mueck
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引用次数: 0

摘要

背景:造血干细胞移植(HSCT)前的预处理会严重损害卵巢功能,导致年轻妇女和女孩不孕和卵巢早衰(POI)。造血干细胞移植前卵巢功能和生育能力的保护至关重要。在中国,许多患者错过了这一机会,这凸显了造血干细胞移植后卵巢功能和生育能力保存的必要性。卵巢组织冷冻保存(OTC)是保留生育能力和保护卵巢功能的标准方法。本病例报告旨在报告一例造血干细胞移植后为 8 岁女孩实施的卵巢组织冷冻保存术,并对造血干细胞移植后卵巢保存的必要性和可行性进行综述:病例:一名 8 岁女孩因皮肌炎复发需要进行第二次造血干细胞移植。手术前,她到我中心进行了卵巢功能检查。通过腹腔镜检查,激素评估结果显示FSH 1.17 IU/L、LH 0.00 IU/L、E2。通过缓慢冷冻保存了7片卵巢皮质组织,每片直径2毫米的皮质组织中平均有1079个卵泡:结论:造血干细胞移植前错过生育力保存时间的患者应在造血干细胞移植后尽早咨询生育力保存和妇科内分泌专家,并进行定期随访。如果临床证据显示卵巢功能残留,应及时讨论生育保护措施。应将 OTC 作为造血干细胞移植后妇女的成功选择进行评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ovarian tissue cryopreservation for an 8 year old girl after hematopoietic stem cell transplantation in China: case report and literature review.

Background: Preconditioning before hematopoietic stem cell transplantation (HSCT) severely damages ovarian function, resulting in infertility and premature ovarian insufficiency (POI) in young women and girls. Ovarian function and fertility preservation before HSCT is crucial. In China, many patients miss this opportunity, highlighting the need for ovarian function and fertility preservation after HSCT. Ovarian tissue cryopreservation (OTC) is a standard method for fertility preservation and protecting ovarian function. The objective of this case report is to report a case of OTC performed on an 8-year-old girl after HSCT, and present a review about the necessity and feasibility of ovarian preservation after HSCT.

Case: An 8-year-old girl required a second HSCT due to a relapse of dermatomyositis. Before the procedure, she visited our center for OTC. Hormonal assessments showed FSH 1.17 IU/L, LH 0.00 IU/L, E2 < 11.80 pg/ml, and AMH 0.81 ng/ml. Pelvic ultrasound revealed bilateral ovarian sizes of approximately 1.5 × 0.7 × 0.7 cm and 1.6 × 0.9 × 0.7 cm, with 10 and 4 visible follicles, respectively. We proceeded with OTC, surgically retrieving the entire left ovary via laparoscopy. Seven ovarian cortical slices were cryopreserved by slow freezing, with an average of 1079 follicles in per 2 mm diameter cortical tissue slice.

Conclusion: Patients who miss fertility preservation before HSCT should consult fertility preservation and gynecological endocrinology experts as early as possible after HSCT and undergo regular follow-up. If clinical evidence indicates residual ovarian function, fertility protection measures should be discussed promptly. OTC should be assessed as a successful option for women after HSCT.

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来源期刊
Gynecological Endocrinology
Gynecological Endocrinology 医学-妇产科学
CiteScore
4.40
自引率
5.00%
发文量
137
审稿时长
3-6 weeks
期刊介绍: Gynecological Endocrinology , the official journal of the International Society of Gynecological Endocrinology, covers all the experimental, clinical and therapeutic aspects of this ever more important discipline. It includes, amongst others, papers relating to the control and function of the different endocrine glands in females, the effects of reproductive events on the endocrine system, and the consequences of endocrine disorders on reproduction
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