OBJECTIVE To evaluate the utility, success, and safety of ovarian tissue cryopreservation and autologous cryopreserved ovarian tissue transplantation for fertility preservation in patients with gynecologic cancers. DATA SOURCES A comprehensive search was performed of the MEDLINE, EMBASE, ClinicalTrials.gov , and Cochrane Library databases to identify relevant studies on the utility and outcomes of ovarian tissue cryopreservation and autologous cryopreserved ovarian tissue transplantation for gynecologic cancers from inception until January 23, 2024. METHODS OF STUDY SELECTION Two reviewers independently performed the study selection, data extraction, and risk-of-bias assessment, and the results were then reviewed together. Twenty-three studies were included in the current systematic review. TABULATION, INTEGRATION, AND RESULTS The resultant data were meta-analyzed to produce a pooled-effect estimate of the utility of ovarian tissue cryopreservation and autologous transplantation in gynecologic cancers as a proportion of all indications. We found that 7.5% and 9.6% of women undergoing ovarian tissue cryopreservation and autologous transplantation, respectively, had gynecologic cancers. In comparison, hematologic malignancies and breast cancer accounted for approximately 66.0% of all indications for these procedures. The return rate for autologous cryopreserved ovarian tissue transplantation in gynecologic cancers (6.0%) was not statistically different from those for other indications. Among women with gynecologic cancer who underwent ovarian stimulation, 27.3% had at least one child, and the ovarian endocrine function was restored in 78.1% of the women after autologous transplantation. The median graft longevity was 32 months, and no graft-site recurrence was reported after autologous transplantation in women with gynecologic cancer. CONCLUSION Our results suggest that ovarian tissue cryopreservation and autologous transplantation are feasible options for preserving ovarian function in women with gynecologic cancers, although ovarian tissue cryopreservation is underutilized, and further studies are needed to determine the longer-term outcomes of autologous transplantation. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42024498522.

中文翻译：

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卵巢组织冷冻保存和移植治疗妇科癌症的效用和结果：系统评价和荟萃分析。


目的 评价卵巢组织冷冻保存和自体冷冻保存卵巢组织移植在妇科癌症患者保留生育能力方面的效用、成功和安全性。数据来源 对 MEDLINE、EMBASE、ClinicalTrials.gov 和 Cochrane Library 数据库进行了全面检索，以确定从开始到 2024 年 1 月 23 日卵巢组织冷冻保存和自体冷冻保存卵巢组织移植治疗妇科癌症的效用和结果的相关研究。研究选择方法 两名评价员独立进行研究选择、资料提取和偏倚风险评估，然后一起评价结果。目前的系统评价纳入了 23 项研究。制表、整合和结果 对所得数据进行荟萃分析，以产生卵巢组织冷冻保存和自体移植在妇科癌症中效用占所有适应症的比例的汇总效应估计。我们发现，接受卵巢组织冷冻保存和自体移植的女性中，分别有 7.5% 和 9.6% 患有妇科癌症。相比之下，血液系统恶性肿瘤和乳腺癌约占这些手术所有适应症的 66.0%。妇科癌症中自体冷冻保存卵巢组织移植的返回率 （6.0%） 与其他适应症的返回率无统计学差异。在接受卵巢刺激的妇科癌症女性中，27.3% 至少有一个孩子，78.1% 的自体移植后女性卵巢内分泌功能恢复。 中位移植物寿命为 32 个月，妇科癌症女性患者自体移植后未报告移植部位复发。结论 我们的结果表明，卵巢组织冷冻保存和自体移植是保留妇科癌症女性卵巢功能的可行选择，尽管卵巢组织冷冻保存未得到充分利用，需要进一步研究来确定自体移植的长期结果。系统综述注册 PROSPERO， CRD42024498522.