185例不同龄女胎卵巢发育及卵巢血管观察

Observation of the ovary development and its blood vessels in185fetuses at different ages

目的为胎儿卵巢移植供体选择和最佳移植方法提供理论依据.方法取185例不同胎龄、因胎儿或孕妇疾病不宜继续妊娠而引产的女胎或死胎、死产的女婴卵巢,在显微镜下进行组织切片检查,观察各胎龄卵巢含有初级卵母细胞、原始卵泡和初级卵泡数,测量各胎龄卵巢大小、卵巢血管外径及观察其血管来源.结果孕21周后卵巢即有大量初级卵母细胞和原始卵泡,两者比例大致相等;孕20～32周卵巢血管外径均＜2 mm;双侧卵巢血管来自肾动脉者占40.54%,来自腹主动脉者占35.14%,右侧卵巢动脉来自腹主动脉、左侧来自肾动脉者占24.32%.结论孕21周以上的卵巢可作移植,卵巢埋植移植术为首选方法.但因卵巢血管外径太细,血管吻合术要求高、难度大、成功率低.

Objective To collect evidences for selecting the donors and optimal approaches for ovary transplantation. Methods Fetal ovaries were sliced for microscopic examination and the number of primary oocytes and primordial follicles therein was observed. The volume of the ovaries and the external diameter of their vessels were measured and the origin of the vessels also observed. Results Primary oocytes and primordial follicles were observed in almost equal abundance in the ovaries of the fetuses 21 weeks or older of age. The diameter of the vessels supplying the ovaries were less than 2 mm, and in 40.54% of the cases, both of the ovary vessels originated from the renal artery, with 35.14% from the aorta; in the 24.32% cases left, the vessels supplying the right ovaries started from the aorta and the other from the renal artery. Conclusion The ovaries of the fetuses 21 weeks or older of age can be used as donors for transplantation, preferentially for implantation, but the vessels are too thin for uneventful anastomosis.