Application of immature oocytes collection during laparoscopic ovarian tissue resection in fertility preservation
10.3760/cma.j.cn101441-20221213-00562
- VernacularTitle:腹腔镜卵巢组织切除术中获取未成熟卵在生育力保存中的应用
- Author:
Xueling SONG
1
;
Jie YAN
1
;
Wen ZHANG
1
;
Shuo YANG
1
;
Jiajia ZHANG
1
;
Rui YANG
1
;
Yan YANG
1
;
Caihong MA
1
;
Rong LI
1
;
Jie QIAO
1
Author Information
1. 北京大学第三医院妇产科生殖医学中心 国家妇产疾病临床医学研究中心（北京大学第三医院）辅助生殖教育部重点实验室（北京大学）北京市生殖内分泌与辅助生殖技术重点实验室 中国医学科学院卵成熟障碍创新单元，北京 100191
- Publication Type:Journal Article
- Keywords:
Hormone replacement therapy;
Fertility preservation;
In vitro maturation;
Ovarian tissue resection
- From:
Chinese Journal of Reproduction and Contraception
2023;43(2):134-139
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility and effective methods of obtaining immature oocytes during laparoscopic ovarian tissue resection in female tumor patients, aiming at oocytes freezing matured in vitro for fertility preservation. Methods:Retrospective analysis was made on the general data, surgical methods and postoperative follow-up data of 22 tumor patients who underwent laparoscopic ovarian tissue resection at the Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital from November 2015 to April 2022. The study group included 14 patients who simultaneously obtained in vitro maturation (IVM) of immature eggs during laparoscopy. Control group included 8 patients who only underwent cortical resection. The operation time, the amount of bleeding, the number of frozen cortex and other data of the two groups were analyzed to evaluate the application value and safety of this method. Furtherly, the study group was divided into two subgroups, the transvaginal egg retrieval subgroup (10 patients) and the translaparoscopic egg retrieval subgroup (4 patients), according to the method of different methods used for egg retrieval. The time of surgery, the number of eggs obtained and the number of frozen cortices were analyzed in both subgroups to evaluate the efficiency of the different methods of egg retrieval. All 22 patients were followed up annually after surgery, analyzing the information of tumor treatment, menstrual status, and if possible, pelvic ultrasound and sex hormone levels, recording ovarian function after tumor treatment in these patients and providing hormone replacement therapy (HRT) within the indications. Results:There were no statistically significant differences between the study group and control group in terms of age, duration of disease, anti-Müllerian hormone (AMH) level, and the number of frozen cortices. But the number of basal sinus follicles (19.71±6.04), procedure time [(68.07±17.35) min], and bleeding volume [9.0 (5.0,10.5) mL] in the study group were higher than those in control group with statistically significant differences [9.25±3.15, P<0.001; (44.25±16.97) min, P=0.005; 3.5 (2.0, 5.0) mL, P=0.001]. In the transvaginal egg retrieval subgroup, the number of oocytes obtained [15.5 (11.0, 21.0)] and age [(27.00±2.94) years] were significantly higher than those in the translaparoscopic egg retrieval subgroup [4.0 (0.8, 10.3), P=0.028;(15.75±2.22) years, P<0.001], while no statistically significant differences were observed between the two subgroups in the number of sinus follicles, time to surgery, and number of frozen cortices. All 7 patients who underwent hematopoietic stem cell transplantation (HSCT) had amenorrhea after discharge, and were given HRT after disease remission, and their physical development and quality of life were maintained and improved. Conclusion:Young oncology patients who underwent ovarian cortical resection with simultaneous acquisition of immature eggs, in vitro matured oocytes freezing increased the chance of fertility preservation. The efficiency of transvaginal acquisition of immature oocytes was higher; the rate of amenorrhea after HSCT was high, and HRT could improve the quality of life of patients.
