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IF 6.6 1区医学 Q1 OBSTETRICS & GYNECOLOGY

Fertility and sterility Pub Date : 2024-12-17 DOI:10.1016/j.fertnstert.2024.12.016

Lara Houeis, Graziella van der Plancke, Catherine Poirot, Luciana Cacciottola, Alessandra Camboni, Isabelle Brocheriou, Jacques Donnez, Marie-Madeleine Dolmans

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引用次数: 0

摘要

目的：研究非促性腺激素剂量的烷化剂对人体卵巢皮质的影响：研究非致癌剂量的烷化剂对人体卵巢皮质的影响：背景：学术研究中心研究对象取回并分析 78 名接受卵巢组织冷冻保存的患者的活检组织。其中，42 人曾接受过化疗（烷化剂，剂量 2），构成化疗组，36 人未接受过任何化疗，构成对照组：卵泡计数和分类、形态学研究、凋亡免疫染色（caspase-3裂解）、活化免疫染色（phospho-Akt）、纤维化（Masson's trichrome）和血管化（von Willebrand因子和平滑肌肌动蛋白）：在青春期前组，对照组检测到 271 个卵泡/mm³，化疗暴露组检测到 501 个卵泡/mm³。在成年组中，对照组患者发现了 4916 个卵泡/mm³，化疗暴露组患者发现了 6570 个卵泡/mm³。两组患者的卵泡密度在任何年龄段都没有差异。卵泡存活率也没有因化疗暴露或年龄而出现明显差异。在所有年龄组中，无论是否接受化疗，未生长卵泡的比例均大于76%，化疗组高于对照组，但差异不明显。成人化疗组的继发性卵泡数量明显少于成人对照组（P=0.009）。在细胞凋亡方面，各年龄组的对照组和化疗组之间均无明显差异。在所有年龄组中，化疗组的活化卵泡数量均高于对照组。在化疗组的 14 名青春期前患者中，有 4 人发现了非典型卵泡区。在这些区域，卵泡密度为 84570 ± 8837 个卵泡/mm³，所有卵泡似乎都无法存活，但没有凋亡迹象：结论：低剂量化疗对卵巢组织没有重大影响，这表明在冷冻保存前接受过某些化疗的卵巢组织与未接受任何化疗的卵巢组织具有可比性，接受过化疗的妇女在卵巢组织移植后的高妊娠率也证明了这一点。因此，先前的化疗不应再成为卵巢组织冷冻保存的禁忌症。

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Low doses of alkylating agents do not harm human ovarian tissue destined for cryopreservation.

Objective: To investigate the impact of non-gonadotoxic doses of alkylating agents on human ovarian cortex.

Design: Retrospective study.

Setting: Academic research center.

Subject: Biopsies from 78 patients who had undergone ovarian tissue cryopreservation were retrieved and analyzed. Among them, 42 had previously been treated with chemotherapy (alkylating agents, dose <3400mg/m²), making up the chemotherapy group, while 36 had not been given any chemotherapy, constituting the control group.

Mean outcome measures: Follicle count and classification, morphology study, immunostaining for apoptosis (cleaved caspase-3), immunostaining for activation (phospho-Akt), fibrosis (Masson's trichrome) and vascularization (von Willebrand factor and smooth muscle actin).

Results: In the prepubertal group, 271 follicles/mm³ were detected in control patients and 501 follicles/mm³ in chemotherapy-exposed subjects. In the adult group, 4916 follicles/mm³ were found in control patients and 6570 follicles/mm³ in chemotherapy-exposed patients. No difference in follicle density was observed between the two groups in any age category. Neither did we encounter any significant difference in follicle viability according to chemotherapy exposure or age. Proportions of non-growing follicles were >76 % in all age groups, irrespective of chemotherapy exposure, and higher, though not significantly, in the chemotherapy group compared to the control group. There were significantly fewer secondary follicles in the adult chemotherapy group than in the adult control group (p=0.009). Concerning apoptosis, no significant difference was observed between control and chemotherapy subjects in any age groups. Numbers of activated follicles were systematically higher in all age categories in the chemotherapy group than the control group. Areas of atypical follicles were noted in 4 out of 14 prepubertal patients in the chemotherapy group. In these areas, follicle density was 84570 ± 8837 follicles/mm³ and all follicles appeared non-viable but showed no sign of apoptosis.

Conclusion: Low-dose chemotherapy had no major impact on ovarian tissue, suggesting that ovarian tissue exposed to some chemotherapy prior to cryopreservation is comparable to ovarian tissue free of any chemotherapy, as clinically demonstrated by high pregnancy rates after ovarian tissue transplantation in women exposed to chemotherapy. Previous chemotherapy should therefore no longer be a contraindication to ovarian tissue cryopreservation.

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来源期刊

Fertility and sterility 医学-妇产科学

CiteScore

11.30

自引率

6.00%

发文量

1446

审稿时长

31 days

期刊介绍： Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.