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Bypassing physiological puberty, a novel procedure of oocyte cryopreservation at age 7: a case report and review of the literature
Fertility and Sterility ( IF 6.7 ) Pub Date : 2020-08-01 , DOI: 10.1016/j.fertnstert.2020.03.009
Foad Azem 1 , Avivit Brener 2 , Gustavo Malinger 3 , Adi Reches 1 , Ariel Many 4 , Yariv Yogev 4 , Yael Lebenthal 2
Affiliation  

OBJECTIVE To report the first successful oocyte cryopreservation in a prepubertal girl. DESIGN Case report and review of the literature. SETTING Tertiary medical center. PATIENT(S) A 7-year-old prepubertal girl with Turner syndrome mosaicism (45,X[37]/47,XXX[15]) who underwent a novel fertility preservation procedure after fertility preservation counseling and informed decision of the parents. INTERVENTION(S) Controlled ovarian hyperstimulation with daily administration of 100 IU recombinant human follicle-stimulating and 50 IU recombinant human luteinizing hormone per milliliter, injection of 250 μg human chorionic gonadotropin was given 36 hours before the follicular aspiration procedure, and oocytes retrieved by a transabdominal ultrasound guided approach. MAIN OUTCOME MEASURE(S) Mature oocyte cryopreservation. RESULT(S) The first cryopreservation cycle with use of a gonadotropin-releasing hormone agonist trigger failed to yield oocytes. The second cycle with human chorionic gonadotropin trigger was successful. Six oocytes were retrieved, and all were mature metaphase 2. The patient was discharged in good condition with no complications. CONCLUSION(S) This novel procedure bypasses the timely physiologic progression of pubertal maturation of the hypothalamic-pituitary-ovarian axis to directly target the ovaries and achieve mature ovarian follicles. This innovative approach offers a new treatment modality for prepubertal girls who need fertility preservation such as in Turner syndrome or in cases that ovarian tissue cryopreservation is contraindicated.

中文翻译:

绕过生理性青春期,一种新的7岁卵母细胞冷冻保存方法:病例报告及文献复习

目的报道首例青春期前女孩成功冷冻卵母细胞。设计案例报告和文献回顾。设置三级医疗中心。患者 (S) 一名 7 岁青春期前女孩,患有特纳综合征嵌合体 (45,X[37]/47,XXX[15]),在接受保留生育咨询和父母知情决定后接受了新的生育保留程序。干预(S)控制性卵巢过度刺激,每天每毫升注射 100 IU 重组人促卵泡激素和 50 IU 重组人促黄体激素,在卵泡抽吸术前 36 小时注射 250 μg 人绒毛膜促性腺激素,并通过经腹超声引导入路。主要结局指标成熟卵母细胞冷冻保存。结果 使用促性腺激素释放激素激动剂触发的第一个冷冻保存周期未能产生卵母细胞。使用人绒毛膜促性腺激素触发的第二个周期是成功的。取卵6枚,2期均成熟,出院时情况良好,无并发症。结论(S) 这种新颖的手术绕过了下丘脑-垂体-卵巢轴青春期成熟的及时生理进展,直接靶向卵巢并获得成熟的卵泡。这种创新方法为需要保留生育能力的青春期前女孩提供了一种新的治疗方式,例如特纳综合征或卵巢组织冷冻保存禁忌的情况。使用人绒毛膜促性腺激素触发的第二个周期是成功的。取卵6枚,2期均成熟,出院时情况良好,无并发症。结论(S) 这种新颖的手术绕过了下丘脑-垂体-卵巢轴青春期成熟的及时生理进展,直接靶向卵巢并获得成熟的卵泡。这种创新方法为需要保留生育能力的青春期前女孩提供了一种新的治疗方式,例如特纳综合征或卵巢组织冷冻保存禁忌的情况。使用人绒毛膜促性腺激素触发的第二个周期是成功的。取卵6枚,2期均成熟,出院时情况良好,无并发症。结论(S) 这种新颖的手术绕过了下丘脑-垂体-卵巢轴青春期成熟的及时生理进展,直接靶向卵巢并获得成熟的卵泡。这种创新方法为需要保留生育能力的青春期前女孩提供了一种新的治疗方式,例如特纳综合征或卵巢组织冷冻保存禁忌的情况。结论(S) 这种新颖的手术绕过了下丘脑-垂体-卵巢轴青春期成熟的及时生理进展,直接靶向卵巢并获得成熟的卵泡。这种创新方法为需要保留生育能力的青春期前女孩提供了一种新的治疗方式,例如特纳综合征或卵巢组织冷冻保存禁忌的情况。结论(S) 这种新颖的手术绕过了下丘脑-垂体-卵巢轴青春期成熟的及时生理进程,直接靶向卵巢并获得成熟的卵泡。这种创新方法为需要保留生育能力的青春期前女孩提供了一种新的治疗方式,例如特纳综合征或卵巢组织冷冻保存禁忌的情况。
更新日期:2020-08-01
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