Frozen ovary restores fertility

Cancer sufferers could postpone pregnancy

    A cancer patient who had part of an ovary removed, frozen and then reimplanted after the disease had been treated, is now pregnant. The 32-year-old woman, who is expecting a baby girl in October, is the first to fall pregnant after such a procedure.
    Scientists are hailing the announcement as a breakthrough for those left infertile by cancer treatment. But some are concerned that the technique could be used by healthy menopausal women who choose to delay motherhood for reasons of convenience.
    The patient developed Hodgkin's lymphoma seven years ago, so doctors removed and froze samples of her ovarian tissue before beginning cancer treatment.
    Last year, with the disease in remission, one sample was thawed and implanted below one of her remaining, non-functioning ovaries. She then became pregnant naturally. However, it has not yet been confirmed that the fertilised egg came from the graft. It is possible then that the woman's remaining ovary may have spontaneously started to work again.
    Marie-Madeleine Dolmans, from the Catholic University of Louvain in Belgium, will discuss the research at the European Society for Human Reproduction and Embryology meeting in Berlin today.
    Although the baby has yet to be born, this is still a landmark finding, says reproductive biologist Kutluk Oktay from Cornell University, New York, who has also been working towards storing and reimplanting ovarian tissue. "The technique could help give cancer patients a much more positive attitude," he says.

Defying menopause

    Researchers have been trying for years to reimplant or transplant functioning ovaries. This week, fertility researcher Claus Yding Anderson from the Copenhagen University Hospital, Denmark, announced that his group had also produced an embryo after reimplanting ovarian tissue into another cancer patient. But the embryo failed to implant in the womb, for unknown reasons. "The new study is fantastic news," he says.
    The development could have implications for people other than cancer patients. Women are born with around 1 million eggs, but those eggs die off as the menopause approaches. So, in theory, women could choose to preserve a sample of ovarian tissue and then reimplant it after their natural fertility had run out.
    "It is too early to say if this will happen," says Oktay. "We do not know how efficient the process is." But if the success rate is 30% or more, similar to that of in vitro fertilization, then it is a possibility. "What's important is that women have the option to choose," he adds.

冷藏卵巢恢复生育能力

海伦·皮尔切（Helen R. Pilcher）

癌症妇女能延期怀孕

把一位癌症妇女的一部分卵巢切下后经冷藏处理，在治疗后再回植体内，现在她怀孕了。十月份将要做母亲的她，今年32岁，是第一个通过此方法怀孕的癌症妇女。

科学家认为此报道对于癌症患者因治疗而暂时不宜生育的妇女来说，无疑是医学上一大突破。而有些人担心，出于某些原因此项技术有可能会被某些健康的妇女应用而延缓更年期的来临。

该病人七年前患何杰金淋巴瘤，所以医生在治疗前把她的一部分卵巢组织取出，并且把它们冷藏起来。

去年，在其疾病缓解的情况下，医生把解冻后的卵巢回植到该妇女体内，不久她怀孕了。当然这个受精卵是否来自这个移植物还有待证实，也有可能是该妇女残留在体内的卵巢功能又自然恢复了。

比利时路维尼（Louvain）天主教大学的玛丽·马德琳·多尔麦斯（Marie-Madeleine Dolmans）今天将在柏林召开的欧洲人类生殖和胚胎协会会议上讨论此事。虽然婴儿还没有降生，但这仍是一个具有里程碑式的发现。纽约科内尔（Cornell）大学生殖生物学家库特卢克·奥克泰（Kutluk Oktay）也一直致力于卵巢组织的贮存和再植研究，他称：“此项技术能够帮助癌症妇女找回自信。”

向更年期挑战

科学家们多年来一直致力于卵巢回植或移植的研究。本周，丹麦哥本哈根大学医学院繁殖研究者克劳斯·丁·本德森（Claus Yding Anderson）宣布，他领导的小组也把一部分卵巢组织回植到一个癌症患者体内，而且胚胎已形成，但是不知何故这个胚胎没有成功地被植入在子宫里。他说，但此项研究的结果是令人鼓舞的。

此项研究无论对癌症患者还是普通人都有着重大意义。妇女一生约有1百万只卵泡，但这些卵泡随着更年期临近，都将最终耗竭。所以，从理论上讲，妇女能够选择保存卵巢组织，等到她们自然生育能力丧失以后再回植体内是切实可行的。

奥克泰（Oktay）说：“现在说这些还为时过早，我们不知道这个结果如何”，但如果成功率如试管婴儿一样超过30%或更多，这还是有可能的，“更重要的是妇女有了更多的选择权。”他补充道。

（朱函亭译自www.nature.com 作者单位：杭州市中医院）