目前卵巢移植施行試管結果並不理想

目前卵巢切除冷凍保存後再移植後誘導排卵+IVF之結果並不理想，

取卵率，卵泡受孕率，胚胎形成率及懷孕率偏低, 30%病患取不到卵子，

原因可能在於卵組織於手術冷凍解凍移植過程受損，內分泌異常，卵細胞成熟異常，子宮化療放射治療受損, etc.

http://humrep.oxfordjournals.org/content/24/11/2778.full

IVF outcome in patients with orthotopically transplanted ovarian tissue

1. Marie-Madeleine Dolmans, 
2. Jacques Donnez1, 
3. Alessandra Camboni,
4. Dominique Demylle, 
5. Christiani Amorim, 
6. Anne Van Langendonckt and
7. Céline Pirard

+Author Affiliations

1. Department of Gynecology, Cliniques Universitaires St. Luc, Université Catholique de Louvain, Avenue Hippocrate, 10 B-1200, Brussels, Belgium

1. 1Correspondence address. Catholic University of Louvain, Avenue Hippocrate 10, Brussels, Belgium. E-mail: donnez@gyne.ucl.ac.be

• Received April 3, 2009.
• Revision received July 13, 2009.
• Accepted July 14, 2009.

 

Next Section

Abstract

BACKGROUND Chemo- or radiotherapy can induce premature ovarian failure (POF), and ovarian tissue cryopreservation and transplantation may be proposed to restore ovarian function. Our aim was to evaluate the quality of oocytes and embryos derived from frozen-thawed transplanted ovarian tissue.

MATERIALS AND METHODS Women were 21–28 years old at tissue cryopreservation. Nine women suffering POF following chemotherapy with or without radiotherapy underwent orthotopic ovarian tissue transplantation. After 12 months of spontaneous cycles without pregnancy, oocyte retrieval was performed in four patients during mildly stimulated or spontaneous cycles. ICSI was performed in all cases, with embryo transfer on day 3. Light and electron microscopy was used to study oocytes and embryos.

RESULTS Signs of ovarian function restoration (estradiol peak, decreased FSH, follicular development) began 16–26 weeks after reimplantation. Twenty-one oocyte retrieval attempts were made. At least one oocyte was collected in 15 cases, giving an empty follicle rate per retrieval of 29% (6/21). Sixteen oocytes were recovered, of which 6 were abnormal or immature (38%) and 10 (62%) were in metaphase II (MII). Three MII oocytes failed to fertilize, two showed abnormal fertilization and five normal MII oocytes successfully fertilized with subsequent normal embryo development (Grade 2), yielding an embryo transfer rate of 24% per retrieval. No pregnancy occurred.

CONCLUSIONS IVF in women with orthotopically grafted frozen-thawed ovarian tissue involves a higher risk of empty follicles, abnormal or immature oocytes, and low embryo transfer rates.