臨床婦人科産科72巻5号

2018年05月発行

今月の臨床 精子・卵子保存法の現在─「産む」選択肢をあきらめないために 配偶子保存の臨床

凍結卵巣移植に伴う問題点

著者： 京野廣一¹ 小幡隆一郎¹ 橋本朋子¹

所属機関： ¹京野アートクリニック高輪

ページ範囲：P.464 - P.467

●疾患により卵巣転移のリスクが異なる

　高リスク : 白血病，神経芽細胞腫，Burkittリンパ腫

　低リスク : Hodgkinリンパ腫，初期乳管がん，子宮頸部扁平上皮癌

●卵巣転移の検査方法

　組織診，免疫化学組織診，RT-PCR，がんパネル検査，免疫不全マウスへの移植，画像診断，腫瘍マーカー

●移植する患者へのインフォームド・コンセント

　検査している組織と移植する組織が異なり，多くは摘出卵巣の5％程度に組織検査が行われているが，現在研究段階である．

参考文献

1）Jensen AK, et al : 86 successful births and 9 ongoing pregnancies worldwide in women transplanted with frozen-thawed ovarian tissue focus on birth and perinatal outcome in 40 of these children. J Assist Reprod Genet 34 : 325─336, 2017

2）Stern CJ, et al : Delivery of twins following heterotopic grafting of frozen-thawed ovarian tissue. Hum Reprod 29 : 1828, 2014

3）Ernst EH, et al : Legal termination of a pregnancy resulting from transplanted cryopreserved ovarian tissue due to cancer recurrence. J Assist Reprod Genet 30 : 975─978, 2013

4）Andersen CY, et al : No malignancy detected in surplus ovarian tissue from a former Ewing sarcoma patient who experienced relapse four years after being grafted with frozen/thawed ovarian tissue. J Assist Reprod Genet 31 : 1567─1568, 2014

5）Dolmans MM, et al : Risk of transferring malignant cells with transplanted frozen-thawed ovarian tissue. Fertil Steril 99 : 1514─1522, 2013

6）Kyono K, et al : Potential indications for ovarian autotransplantation based on the analysis of 5,571 autopsy findings of females under the age of 40 in Japan. Fertil Steril 93 : 2429─2430, 2010

7）Rosendahl M, et al : The safety of transplanting cryopreserved ovaian tissue in cancer patients : a review of the literature. J Assist Reprod Genet 30 : 11─24, 2013

8）Meirow D : Fertility preservation and minima residual disease. 第15回 東北ART研究会，2016

9）Kyono K, et al : A review : the essentials of informed consent for cancer patients before autologous transplantation of ovarian tissue. J Mamm Ova Res 33 : 115─118, 2016

10）Nakamura Y, et al : Residual ethylene glycol and dimethyl sulphoxide concentration in human ovarian tissue during warming/thawing steps following cryopreservation. Reprod Biomed Online 35 : 311─313, 2017

11）Obata R, et al : Comparison of residual dimethyl sulfoxide（DMSO） and ethylene glycol（EG） concentration in bovine ovarian tissue during warming steps between slow freezing and vitrification methods. P-513, ESHRE, 2017

12）Kyono K, et al : A transportation network for human ovarian tissue is indispensable to success for fertility preservation. J Assist Reprod Genet 34 : 1469─1474, 2017

13）Meirow D, et al : Transplantations of frozen thawed ovarian tissue demonstrate high reproductive performance and the need to revise restrictive criteria. Fertil Steril 106 : 467─474, 2016

14）Kristensen SG, et al : Fertility preservation and refreezing of transplanted ovarian tissue-a potential new way of managing patients with low risk of malignant cell recurrence. Fertil Steril 107 : 1206─1213, 2017