| 摘要: |
| ［摘要］ 目的 探讨青春期前女童卵巢组织冻存及自体移植在恢复卵巢内分泌功能和诱导青春期发育中的可行性与效果。方法 1例噬血细胞综合征患儿，7岁时在造血干细胞移植前行单侧卵巢组织冻存，造血干细胞移植后出现卵巢功能衰竭及青春期未启动。12岁时行冻存卵巢组织自体移植，术后随访性激素水平、子宫发育及青春期体征变化。结果 卵巢组织移植后4个月卵泡刺激素明显下降，子宫体积显著增大，提示卵巢内分泌功能恢复。移植后8个月出现月经初潮，乳房及外阴发育。超声显示移植物内可见多个卵泡，骨密度及身高发育较前明显改善，成功诱导青春期发育。结论 青春期前卵巢组织冻存并经长期保存后实施自体移植，可有效恢复卵巢内分泌功能并诱导青春期发育，为需接受性腺毒性治疗的儿童患者提供重要的生育力及内分泌功能保护策略。 |
| 关键词: 卵巢组织冻存 早发性卵巢功能不全 造血干细胞移植 生育力保护 |
| DOI：10.3969/j.issn.1674-3806.2026.03.08 |
| 分类号:R 711 |
| 基金项目:国家外国专家个人类项目（编号：S20240236，S20240230）；北京市自然科学基金项目（编号：7202047） |
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| First successful restoration of ovarian endocrine function after childhood ovarian tissue cryopreservation and subsequent transplantation in China: a case report and literature review |
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GU Muqing1, RUAN Xiangyan1, DU Juan1, JIN Fengyu1, CHENG Jiaojiao1, LI Yanglu1, LI Yanqiu1, WANG Zecheng1, ZHANG Mingzhen1, Matthias Korell2, Alfred O. Mueck3
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1.Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China; 2.Department of Obstetrics and Gynecology, Johanna Etienne Hospital of Neuss, Neuss 41462, Germany; 3.Section of Endocrinology and Menopause, Department of Women′s Health, University of Tuebingen, Tuebingen 72076, Germany
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| Abstract: |
| ［Abstract］ Objective To explore the feasibility and effectiveness of ovarian tissue cryopreservation(OTC) and autologous transplantation in pre-adolescent female children for restoring ovarian endocrine function and inducing pubertal development. Methods A retrospective analysis was conducted on a case of hemophagocytic syndrome. The patient underwent unilateral ovarian tissue cryopreservation at the age of 7 years before hematopoietic stem cell transplantation. After the transplantation, she developed ovarian failure and failed to initiate puberty. At the age of 12 years, autologous transplantation of the cryopreserved ovarian tissues was performed on her. Her sex hormone levels, uterine development and changes in signs of pubertal development were observed during the postoperative follow-up. Results Four months after ovarian tissue transplantation, the patient′s follicle-stimulating hormone levels significantly decreased and uterine volume significantly increased, indicating the recovery of ovarian endocrine function. Eight months after the transplantation, the patient experienced menarche, and her breasts and vulva developed. Ultrasound examination showed multiple ovarian follicles in the graft, and her bone mineral density and height growth after the transplantation were significantly improved compared with those before the transplantation, indicating that the patient′s pubertal development was successfully induced. Conclusion OTC before puberty and long-term preservation followed by autologous transplantation can still effectively restore the ovarian endocrine function of the transplanted child and induce her pubertal development, which provides an important strategy of fertility and endocrine function protection for the child patients who need to receive treatments leading to gonadal toxicity. |
| Key words: Ovarian tissue cryopreservation(OTC) Premature ovarian insufficiency(POI) Haematopoietic stem cell transplantation Fertility preservation |
