卵巢体外灌注和冷冻保存新策略和新系统:一项创新

Mohamed Shehata Ali Mohamed
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引用次数: 2

摘要

患有癌症的儿童和年轻人接受了促性腺毒素治疗,这破坏了他们生存后的生育能力。卵巢冷冻保存和移植为这一问题提供了有希望的解决方案,卵巢可以在促性腺毒素治疗前切除,在患者存活后重新植入,在治疗期间卵巢将被冷冻保存。然而,整个卵巢的低温保存仍然面临着很大的障碍,即缺血再灌注损伤和低温保存的缺陷,这与通过卵巢血管床普遍递送低温保存/加热溶液的能力不足有关。同时,目前应用的卵巢组织冷冻保存技术对卵泡的恢复有限,因为许多卵泡在移植后血管重建发展之前就已经丢失。为了解决这些问题,一种创新的系统已经被开发出来,以确保快速和普遍地将冷冻保存/加热溶液输送到移植物中,除了在冷冻保存前后保持移植物持续灌注,最大限度地减少微血栓形成或缺血再灌注的机会。该创新系统可应用于以下手术和临床干预:1)异基因卵巢移植;2)年轻女性全身化疗或骨髓移植后保留生育能力,在治疗前切除卵巢,暴露于系统提供的充分低温保存,直至患者存活后再植入;3)该系统也适用于睾丸的相应应用。
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A new strategy and system for the ex vivo ovary perfusion and cryopreservation: An innovation
Children and young adults, who suffer from cancer, receive gonadotoxic therapy, which destroys their fertile abilities after survival. Ovarian cryopreservation and transplantation provide the promising solution to this problem, where the ovary can be removed before the gonadotoxic therapy and reimplanted after patient's survival, where the ovary is to be cryopreserved during the period of the therapy. However, cryopreservation of the whole ovary is still facing great obstacles, namely the ischemic reperfusion injury and the defective cryopreservation related to the defective ability to universally deliver the cryopreservation/warming solutions through the ovarian vascular bed. Meanwhile, the currently applied technique of ovarian tissue cryopreservation provides limited follicular recovery because many follicles are lost until the development of revascularization post-transplantation. To solve the problems, an innovative system has been developed to insure immediate and universal delivery of the cryopreservation/warming solutions to the graft, in addition to keeping the graft under continuous perfusion before and after cryopreservation, minimizing any chance for microthrombi formation or ischemia-reperfusion. This innovative system can be applied in the following surgical and clinical interventions: 1) Allogeneic ovarian transplantation; 2) Preservation of fertility after systemic chemotherapy or bone marrow transplantation in young females, where the ovaries could be removed before the therapy and exposed to the adequate cryopreservation provided by the system till re-implantation after the patient's survival; 3) The system is also suitable for the corresponding applications on the testicles.
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6-12 weeks
期刊最新文献
The status of depression and anxiety in infertile Turkish couples Vaginal compared oral administration of estradiol in women with thin endometrium: A cross-sectional study Corrigendum to “Interstitial ectopic pregnancy diagnosis by three-dimensional ultrasound and its laparoscopic management: A case report” [Int J Reprod BioMed 2019; 17: 945-950] A new strategy and system for the ex vivo ovary perfusion and cryopreservation: An innovation The etiologies of DNA abnormalities in male infertility: An assessment and review
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