交界性卵巢肿瘤保留生育功能治疗方法进展

Progress of Fertility Preservation Treatments in Patients with Borderline Ovarian Tumors

保留生育功能的手术治疗是交界性卵巢肿瘤(borderline ovarian tumors,BOTs)年轻患者保留生育能力的最佳治疗手段。保留生育功能的手术不仅对早期BOTs患者较安全,对于晚期有卵巢外种植的患者,若病灶可完全摘除,也可接受此种手术治疗。术后妊娠率可观,且大部分可通过自然方式妊娠。术后妊娠对病程影响较小,妊娠并发症也很少发生。早期BOTs患者术后不孕可给予促排卵药物治疗,但晚期患者则需要谨慎对待。若病变累及双侧卵巢不宜进行保守性手术,可选择胚胎冻存、卵母细胞冻存、卵巢组织冻存、接受卵母细胞赠送等方法。

Facing to young patients with borderline ovarian tumors （BOTs） ,fertility preservation surgery is the best option to preserve fertility. Fertility preservation surgery is acceptable not only for patients with early-stage BOTs but also for someone with noninvasive extra-ovarian implants which can be resected completely. The pregnancy outcomes after surgery is recognized and most of the pregnancies have been achieved spontaneously. The complications followed by pregnancy are few, and pregnancy seems to have little impact on disease progression. Superovulation drugs are tolerated in early-stage BOTs patients who experience infertility after surgery,but it should be caution when using these drugs in advanced-stage BOTs patients after surgery. If the normal ovarian portion cannot be preserved due to massive bilateral ovarian involvement and only the uterus can be preserved,the surgery can not be choosed. But there are several alternative options for fertility preservation, such as embryo freezing, oocyte, ovarian tissue freezing; and using donor ooccytes.