OBJECTIVE To report ovarian tissue autotransplantation (AT) results and describe the relationship between technical and clinical factors and outcomes. DESIGN Multicenter retrospective cohort study. SETTING Tertiary medical centers. PATIENT(S) Infertile patients who had stored ovarian tissue before sterilizing treatment and returned for AT with the aim of conceiving. INTERVENTIONS(S) Ovarian tissue cryopreservation (OTC) and AT, endocrine monitoring, in vitro fertilization. MAIN OUTCOME MEASURE(S) Endocrine performance, pregnancy and live-birth rates. RESULT(S) From 2004 to 2018, 70 patients underwent 87 ATs. Sixty patients undergoing 70 ATs met the inclusion criteria. After AT, menses returned in 94% of patients and median FSH dropped from 68 to 19 IU/mL. Fifty pregnancies and 44 deliveries were attained, with 50% of women achieving at least one pregnancy and 41.6% at least one delivery. Twelve patients underwent AT more than once and had their endocrine activity restored in case menses recurred after the first transplantation. Repeated transplantations yielded five live births in three patients, two of whom had already given birth after the first transplantation. Preharvesting chemotherapy was not associated with inferior outcomes. Of seven patients whose pelvis was exposed to radiation before AT, four conceived and delivered. Neither tissue dimensions nor surgical approach affected fertility outcomes. CONCLUSION(S) OTC is highly effective at restoring fertility in sterilized patients, and prior exposure to chemotherapy should not be considered a contraindication. Repeated AT should be contemplated in case of graft malfunction, especially if previous transplantation was successful. In selected cases, conception and delivery may be feasible after pelvic exposure to radiation.

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卵巢组织移植的评估：来自三个临床中心的结果

目的 报告卵巢组织自体移植 (AT) 结果并描述技术和临床因素与结果之间的关系。设计 多中心回顾性队列研究。设置三级医疗中心。PATIENT(S) 在绝育治疗前储存卵巢组织并以受孕为目的返回 AT 的不育患者。干预措施(S) 卵巢组织冷冻保存 (OTC) 和 AT、内分泌监测、体外受精。主要结局指标 内分泌表现、妊娠率和活产率。结果 从 2004 年到 2018 年，70 名患者接受了 87 次 AT。60 名接受 70 次 AT 的患者符合纳入标准。AT 后，94% 的患者月经恢复，FSH 中位数从 68 IU/mL 降至 19 IU/mL。实现了 50 次怀孕和 44 次分娩，50% 的妇女至少怀孕一次，41.6% 的妇女至少分娩一次。12 名患者接受了不止一次 AT，并且在第一次移植后月经复发的情况下恢复了内分泌活动。重复移植在三名患者中产生了五次活产，其中两人在第一次移植后已经分娩。收获前化疗与较差的结果无关。在 AT 前骨盆暴露于辐射的 7 名患者中，有 4 名受孕并分娩。组织尺寸和手术方法均不影响生育结果。结论 (S) OTC 在恢复绝育患者的生育能力方面非常有效，并且不应将先前接受化疗视为禁忌症。在移植物故障的情况下，应考虑重复 AT，尤其是如果之前的移植成功的话。在某些情况下，盆腔暴露于辐射后受孕和分娩可能是可行的。