Individuals with a disease or treatment that increases their risk of premature gonadal insufficiency may opt to undergo fertility preservation. Those who are postpubertal can often cryopreserve gametes, sperm, or eggs to expand their biologic family using assisted reproductive technologies. Ovarian tissue cryopreservation (OTC) and testicular tissue cryopreservation may be an option for individuals who are unable to use standard fertility preservation techniques. The development of OTC was critical for many patients, including prepubertal children with ovaries that do not yet produce eggs, adolescents who make few good-quality eggs, and adult women with ovaries who cannot undergo ovarian stimulation. The only option to restore fertility and hormone production after OTC is through ovarian tissue transplantation (OTT). Ovarian tissue cryopreservation and OTT have been successful for some patients. Although OTC is no longer considered experimental by the American Society for Reproductive Medicine, the process is far from standardized. Significant research needs to be done, especially at the point of OTT, to improve the success and longevity of ovarian tissue function. This article lists the main steps from surgical procurement of the ovarian tissue to transplantation and restoration of function. Our pediatric hospital program has had to decide which options in procurement, processing, cryopreservation, and warming will be used in our clinical laboratory. The options and limitations within the research and analyses are briefly discussed. Literature focusing on techniques to improve OTT effectiveness and longevity was reviewed. Ovarian tissue transplantation studies that performed xenograft experiments after pretreatment of the tissue graft by a ligand or drug, treatment of the host, or encapsulation of the ovarian tissue were identified. The intended effects of the treatments include increasing vascularization, reducing apoptosis, and directing activation or suppression of primordial follicles. Robust research in this area must continue with rigorous analyses to make strides in improving fertility preservation and restoration options for patients.

中文翻译：

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解冻生育能力：卵巢组织冷冻保存过程的观点和卵巢移植研究的回顾


患有会增加性腺过早功能不全风险的疾病或治疗的个体可能会选择接受生育力保存。青春期后的人通常可以冷冻保存配子、精子或卵子，以利用辅助生殖技术扩大其生物家族。对于无法使用标准生育力保存技术的个人来说，卵巢组织冷冻保存 (OTC) 和睾丸组织冷冻保存可能是一种选择。 OTC 的发展对许多患者至关重要，包括卵巢尚未产生卵子的青春期前儿童、产生优质卵子很少的青少年，以及卵巢无法接受卵巢刺激的成年女性。 OTC 后恢复生育能力和激素产生的唯一选择是通过卵巢组织移植 (OTT)。卵巢组织冷冻保存和 OTT 对一些患者已取得成功。尽管美国生殖医学会不再认为 OTC 处于实验阶段，但该过程远未标准化。需要进行大量研究，特别是在 OTT 方面，以提高卵巢组织功能的成功率和寿命。本文列出了从手术获取卵巢组织到移植和功能恢复的主要步骤。我们的儿科医院项目必须决定我们的临床实验室将使用哪些采购、加工、冷冻保存和加温选项。简要讨论了研究和分析中的选择和局限性。回顾了重点关注提高 OTT 有效性和寿命的技术的文献。 确定了在用配体或药物预处理组织移植物、治疗宿主或封装卵巢组织后进行异种移植实验的卵巢组织移植研究。治疗的预期效果包括增加血管形成、减少细胞凋亡以及指导原始卵泡的激活或抑制。该领域的稳健研究必须继续进行严格的分析，以在改善患者生育力保存和恢复选择方面取得进展。