Aktuelle Möglichkeiten der konventionellen langsamen Kryokonservierung sowie der Vitrifikation von humanem Ovarialgewebe

Zusammenfassung

Die konventionelle langsame Kryokonservierung oder die Vitrifikation von humanem Ovarialgewebe zum Erhalt der Fertilität oder späteren Vermeidung einer Hormonsubstitution besitzen angesichts des verbesserten Langzeitüberlebens nach malignen Erkrankungen eine zunehmende Bedeutung. Wir wissen heute, dass sowohl nach konventioneller Kryokonservierung als auch nach Vitrifikation mit großer Wahrscheinlichkeit vitales Gewebe erhalten bleibt. Unklar bleibt aber weiterhin die optimale Verwendung des Gewebes. Die Autotransplantation führte bisher lediglich zu einer passageren Follikelreifung bzw. Hormonsynthese.

Weitere klinische Studien an einer größeren Patientenzahl sind erforderlich, um die Langlebigkeit der Transplantate, die längerfristige Hormonsynthese und Follikelreifung, die Möglichkeit und den Verlauf von Schwangerschaften sowie die Sicherheit der Autotransplantation bei malignen Erkrankungen zu evaluieren. Unabhängig davon könnte sich auch bei humanem Ovarialgewebe die Vitrifikation zu einer zeit- und kostensparenden Alternative entwickeln. Derzeit sind die Untersuchungen zur konventionellen langsamen Kryokonservierung weiter fortgeschritten als die zur Vitrifikation.

Unter der Voraussetzung, dass die Patientinnen kritisch über die aktuellen Möglichkeiten und Probleme der Methoden aufgeklärt sind, ist zum jetzigen Zeitpunkt eine konventionelle langsame Kryokonservierung von humanem Ovarialgewebe gerechtfertigt.

Abstract

Improved survival after gynecologic and other malignancies is making techniques to preserve ovarian tissue for future hormone production and fertility increasingly important. Human ovarian tissue can be preserved with both slow cryopreservation and vitrification. However, to date autotransplantation of ovarian tissue has resulted in only temporary follicle maturation or hormone synthesis. Ongoing research is aiming to improve the longevity of transplants and to evaluate the possibility and outcome of pregnancy after autotransplantation in patients after cancer. While vitrification has the future potential to save time and money, studies on slow cryopreservation are further advanced at this point and with appropriate informed consent slow cryopreservation is justified for selected women.

Schlüsselwörter

Humanes Ovarialgewebe - Kryokonservierung - Vitrifikation

Key words

Human ovarian tissue - cryopreservation - vitrification

Literatur

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