医源性卵巢储备功能减退患者的卵母细胞冷冻生育力保存应用

doi:10.12280/gjszjk.20230306

摘要/Abstract

摘要：

自1986年首次成功利用卵母细胞冷冻复苏后获得双胎妊娠以来，卵母细胞冷冻逐步成为医源性卵巢功能降低的干预措施。近年来，卵巢储备功能减退（diminished ovarian reserve，DOR）患者数量呈上升趋势，其生育力保存越来越受到重视。DOR的医源性影响因素主要包括生殖系统手术和肿瘤放化疗等。卵母细胞冷冻是生育力保存的一线治疗方案，在医源性DOR患者临床应用中的安全性、适用性、利用率及赠卵治疗方面已有临床数据及相关文献证实，但卵母细胞冷冻时机的选择、临床应用局限性及伦理政策等相关问题也不容忽视。卵母细胞冷冻对改善医源性DOR未婚患者的妊娠结局及已婚患者的生殖自主性具有重大意义，在明确DOR的医源性影响因素后，可尽早请肿瘤科、妇科、生殖科等多学科会诊，为患者制定个体化的卵母细胞冷冻保存方案。

关键词: 卵母细胞, 玻璃化冷冻, 生育力, 肿瘤, 妇科外科手术, 生殖技术，辅助, 卵巢储备功能减退

Abstract:

Since the first successful use of oocyte cryopreservation and resuscitation, to obtain twin pregnancies, in 1986, oocyte cryopreservation has gradually become an intervention measure for iatrogenic ovarian dysfunction. In recent years, the number of patients with diminished ovarian reserve (DOR) has shown an increasing trend, and the preservation of their fertility is receiving increasing attention. The iatrogenic influencing factors of DOR mainly include reproductive system surgery, tumor radiotherapy and chemotherapy, etc. Oocyte cryopreservation is a first-line treatment option for fertility preservation, and its safety, applicability, utilization rate, and egg donation treatment in the clinical application of iatrogenic DOR patients have been confirmed by clinical data and relevant literature. However, the issues related to the timing of oocyte cryopreservation, limitations of clinical application and ethical policies cannot be ignored. Oocyte cryopreservation is of great significance for improving the pregnancy outcomes of unmarried patients with iatrogenic DOR and the reproductive autonomy of married patients. After clarifying the iatrogenic influencing factors of DOR, it is recommended to seek consultation from multiple disciplines such as oncology, gynecology and reproductive health as soon as possible to develop the personalized oocyte cryopreservation plans.

Key words: Oocytes, Vitrification freezing, Fertility, Neoplasms, Gynecologic surgical procedures, Reproductive techniques, assisted, Diminished ovarian reserve

叶明珠, 郑洁, 李杰芃, 许莉欣. 医源性卵巢储备功能减退患者的卵母细胞冷冻生育力保存应用[J]. 国际生殖健康/计划生育杂志, 2023, 42(6): 498-502.

YE Ming-zhu, ZHENG Jie, LI Jie-peng, XU Li-xin. Application of Oocyte Cryopreservation in Patients with Iatrogenic Diminished Ovarian Reserve[J]. Journal of International Reproductive Health/Family Planning, 2023, 42(6): 498-502.

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