卵巢移植及移植卵巢的保存

Ovary transplantation and its preservation

目的:结卵巢移植的研究现状及卵巢组织的冷冻解冻方法。资料来源:应用计算机检索Medline1996-01/2006-12与卵巢移植相关的文章,检索词为“ovary transplantation,auto-ovary transplantation,heterologous transplantation,cryopreservation,vitrification,hysterocarcinoma”,限定文献语种为“English”;同时检索万方数据库2000-01/2006-12相关文章,检索词为“卵巢移植,自体移植,异种移植,低温保存,玻璃化冷冻”,限定文献语种为中文。资料选择:共检索到相关文献280余条,选择卵巢移植及卵巢组织的冷冻解冻方法相关文章,无论观察对象是人还是动物均纳入,筛除明显重复文献。资料提炼:将筛选的文献进一步查找全文,纳入35条文献进行综述。其中26篇论述卵巢的自体移植、异体移植及异种移植的研究进展,另外9篇是介绍卵巢组织的冷冻解冻方法以及各种方法的差异。资料综合:目前卵巢的移植可以分为自体移植、异体移植、异种移植:①目前人类卵巢组织的自体移植无论是异位还是原位移植有效性和实用性尚不完全清晰。理论上自体原位移植在卵泡的发育和恢复生育功能上更具有优势,但是,在实际观测临床应用中,卵巢组织自体异位移植仍然是最佳首选。②目前同种异体移植面临的最大难题就是免疫排斥反应,其次是受体提供者的问题;另外胚胎卵巢组织作为移植物所具有的优越性越来越受到关注,但是在应用于临床中除了有伦理道德等社会问题,还存在潜在的检测不出的基因的异常表达等技术检测问题需要解决。③异种移植仅处于实验室研究阶段,迄今为止绵羊、猪、猫、猴和人等卵巢组织已经作为材料用于实验室异种移植中。在卵巢组织的移植过程中,卵巢组织的冷冻方法有慢速冷冻法、快速冷冻法和玻璃化冷法;大多数冻存的卵巢组织应用快速复温法解冻。结论:随着免疫移植学、卵巢组织冻存技术的发展,卵巢组织的移植技术将成为解决女性生殖及内分泌的最佳有效途径。但是就目前发展状况来看,还存在许多亟待解决的问题。

OBJECTIVE： To summarize the present researches of ovary transplantation and the freezing defrosting method of ovary tissue. DATA SOURCES： From January 1996 to December 2006, the articles of ovary transplantation were identified using computer search of Medline, with the retrieval words of ＂ovary transplantation, auto-ovary transplantation, heterologous transplantation, cryopreservation, vitrification, hysterocarcinoma＂, the literature language was classified as English; Simultaneously, the related Chinese articles were retrieved in Wanfang database between January 2000 and December 2006, the retrieval word was ＂ovary transplantation, auto-transplantation, hetero-transplantation, low temperature preservation, vitrification freezing＂, the literature language was classified as Chinese. STUDY SELECTION： Over 280 correlated literatures were screened out, those of the ovary transplantation and freezing defrosting method of ovary tissue were selected, regardless of the object was the human or the animal. The obvious repetition literatures were screened out. DATA EXTRACTION： All the selected literatures were further searched for the full texts, and 35 of them were involved to carry on the summary, including 26 papers elaborates the research process of the ovary auto-transplantation, allo-transplantation and hetero-transplantation, moreover 9 papers introduced the freezing defrosting method of ovary tissue and the difference of various methods. DATA SYNTHESIS： At present, the ovary transplantation may be divided into the auto-transplantation, allo-transplantation, the hetero-transplantation：（1）Currently the auto-transplantation of human ovary tissue, regardless of the dystopia or the home position, presents the unclear validity and utility. Theoretically the ovary auto-transplantation through home position is superior for the development of follicle and the restore of fertility, but the dystopia allo-transplantation is still the optimal choice in the clinical practice. （2）Now, the homogeneous hetero-transplantation faces many difficult problems, firstly the immunity repel response, next the acceptor tenderer; Moreover the embryo ovary tissue becomes more and more attractive due to the superiority as a transplant, but clinical application need to solve the problems of not only ethics and morality, but also the technical examination of gene expression, which is latent and undetected.（3）The hetero-transplantation is at the laboratory research stage only, until now many ovary tissues have already been used in the laboratory as the material, such as sheep, pig, cat, monkey and human. The freezing method of ovary tissue in the transplant includes the slow refrigeration, the fast refrigeration and the vitrification cold process; and repaid rewarming is a major way to defrost the ovary tissue. CONCLUSION： Along with the advancement of immunity transplant study and the cryopreservation technique of ovary tissue, the transplant of ovary tissue will become the best effective way to solve the feminine reproduction and the endocrine. But many unsolved problems need an urgent exploration.