oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2024-23-4-96-107oncotomsk-3196Research ArticleОПЫТ РАБОТЫ ОНКОЛОГИЧЕСКИХ УЧРЕЖДЕНИЙONCOLOGY PRACTICEOТО-IVM – метод сохранения фертильности пациенткам с опухолевым поражением яичниковOTO-IVM is a method of fertility preservation for patients with ovarian tumorshttps://orcid.org/0000-0002-1886-3993ЛавриновичО. Е.LavrinovichO. E.

Лавринович Ольга Евгеньевна, кандидат медицинских наук, научный сотрудник отделения онкогинекологии

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

Olga E. Lavrinovich, MD, PhD, Researcher, Department of Gynecological Oncology

68, Leningradskaya St., Saint Petersburg, Pesochny village, 197758

https://orcid.org/0009-0000-9472-5704ТатищеваЮ. А.TatischevaYu. A.

Татищева Юлия Александровна, кандидат биологических наук, эмбриолог; заведующая эмбриологической лабораторией

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

 191186, г. Санкт-Петербург, Невский пр., 22–24

Yulia A. Tatischeva, PhD, Embryologist; Head of the Embryology Laboratory

68, Leningradskaya St., Saint Petersburg, Pesochny village, 197758

22–24, Nevsky Ave., Saint Petersburg, 191186

https://orcid.org/0000-0001-6937-2740БерлевИ. В.BerlevI. V.

Берлев Игорь Викторович, доктор медицинских наук, профессор, заведующий отделением онкогинекологии; заведующий кафедрой акушерства и гинекологии

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68 

191015, г. Санкт-Петербург, ул. Кирочная, 41

Igor V. Berlev, MD, Professor, Head of the Department of Oncogynecology; Head of the Department of Obstetrics and Gynecology

68, Leningradskaya St., Saint Petersburg, Pesochny village, 197758

41, Kirochnaya St., Saint Petersburg, 191015

https://orcid.org/0000-0002-1593-6771ЯковлеваМ. Г.YakovlevaM. G.

Яковлева Мария Георгиевна, кандидат медицинских наук, сотрудник отделения онкогинекологии

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

Maria G. Yakovleva, MD, PhD, Researcher, Department of Gynecological Oncology

yakovleva.maria.g@gmail.comhttps://orcid.org/0009-0002-0216-2727КарицкийА. П.KaritskiA. P.

Карицкий Андрей Петрович, кандидат медицинских наук, заместитель директора по лечебной работе

197758, г. Санкт-Петербург, пос. Песочный, ул. Ленинградская, 68

Andrey P. Karitski, MD, PhD, Deputy Director

68, Leningradskaya St., Saint Petersburg, Pesochny village, 197758

https://orcid.org/0000-0002-4796-7812КалугинаА. С.KaluginaA. S.

Калугина Алла Станиславовна, генеральный директор; доктор медицинских наук, профессор, профессор кафедры акушерства, гинекологии и неонатологии

191186, г. Санкт-Петербург, Невский пр., 22–24

197022, г. Санкт-Петербург, ул. Льва Толстого, 6–8

Alla S. Kalugina, General Director; MD, Professor, Department of Obstetrics, Gynecology and Neonatology

22–24, Nevsky Ave., Saint Petersburg, 191186

6–8, Lev Tolstoy St., Saint Petersburg, 197022

ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова» Минздрава РоссииРоссияN.N. Petrov National Medical Oncology Research Center of the Ministry of Health of RussiaRussian FederationФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова» Минздрава России; Клиника репродуктивной медицины «Скайферт»РоссияN.N. Petrov National Medical Oncology Research Center of the Ministry of Health of Russia; Clinic of Reproductive Medicine “Skyfert”Russian FederationФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Петрова» Минздрава России; ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И.И. Мечникова» Минздрава РоссииРоссияN.N. Petrov National Medical Oncology Research Center of the Ministry of Health of Russia; I.I. Mechnikov North-Western State Medical University of the Ministry of Health of RussiaRussian FederationКлиника репродуктивной медицины «Скайферт»; ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова» Минздрава РоссииРоссияClinic of Reproductive Medicine “Skyfert”; I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Health of RussiaRussian Federation20240909202423496107Copyright © Лавринович О.Е., Татищева Ю.А., Берлев И.В., Яковлева М.Г., Карицкий А.П., Калугина А.С., 20242024Лавринович О.Е., Татищева Ю.А., Берлев И.В., Яковлева М.Г., Карицкий А.П., Калугина А.С.Lavrinovich O.E., Tatischeva Y.A., Berlev I.V., Yakovleva M.G., Karitski A.P., Kalugina A.S.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/3196

Введение. Все большее число пациенток репродуктивного возраста сталкивается с онкологическим заболеванием и высоко заинтересованы в сохранении фертильности. Улучшаются показатели выживаемости онкологических пациентов. Совершенствуются методы репродуктивных технологий, позволяющие сохранить способность деторождения. Реабилитация с целью обеспечения удовлетворительного качества жизни приобретает новый смысл, а с развитием новых технологий изменяется и уровень возможной помощи. В настоящее время реабилитационные мероприятия для онкологических пациенток репродуктивного возраста, несомненно, должны включать все возможные меры по сохранению и восстановлению фертильности. Цель исследования – сохранение фертильности пациенток с опухолевым поражением яичников. Материал и методы. После овариоэктомии яичники транспортировали в лабораторию эмбриологии, где проводили извлечение ооцит-кумулюсных комплексов и их последующее дозревание методом OTO-IVM (Ovarian tissue oocyte in vitro maturation). Полученные зрелые ооциты (метафаза II) криоконсервировали методом витрификации или, при наличии партнера, оплодотворяли методом ИКСИ (интрацитоплазматической инъекции сперматозоида), эмбрионы культивировали до стадии бластоцисты и также криоконсервировали методом витрификации. Криоконсервированные ооциты и эмбрионы могут быть использованы после излечения онкологического заболевания в программах вспомогательных репродуктивных технологий. Результаты. Всего было извлечено 218 ОКК, из них ооцитов с деградацией – 65 (29,8 %), ОКК, пригодных для дозревания – 153 (70,2 %). Через 36 или 48 ч у 13 пациенток дозрели 65 ооцитов, что составило 42,5 % от ооцитов без признаков деградации. У 11 пациенток, включенных в исследование, извлечение ОКК выполнено из пораженного опухолью яичника. Получено 149 ооцитов, из них 50 (33,6 %) – ооциты с признаками деградации. Остальные 99 (66,4 %) ОКК – удовлетворительного качества, после проведения дозревания метафазы II достигли 49 (49,5 %) ооцитов. В рамках данной работы у 13 из 15 пациенток криоконсервирован биологический материал: 5 эмбрионов и 60 ооцитов.

Introduction. An increasing number of patients of reproductive age get cancer and are highly interested in preserving fertility. Survival rates for cancer patients are improving. Methods of reproductive technologies are being improved to preserve the ability to bear children. Rehabilitation aimed to ensure a satisfactory quality of life takes on a new meaning, and with the development of new technologies, the level of possible assistance also changes. Today, rehabilitation measures for cancer patients of reproductive age should undoubtedly include all possible ways to preserve and restore fertility. Aim: preservation of fertility in patients with ovarian tumors. Material and Methods. After ovariectomy, the ovaries were transported to the embryology laboratory, where oocyte-cumulus complexes were extracted and subsequently matured using the OTO-IVM (ovarian tissue oocyte in vitro maturation) method. The resulting mature oocytes (Metaphase II) were cryopreserved by vitrification or, if a partner was available, fertilized by ICSI (intracytoplasmic sperm injection), the embryos were cultured to the blastocyst stage and also cryopreserved by vitrification. Cryopreserved oocytes and embryos can be used by patients after cancer treatment in assisted reproductive technology programs. Results. A total of 218 OCCs were recovered, 29.8 % were degraded oocytes (n=65). The proportion of OCC suitable for ripening was 153 (70.2 %). After 36 or 48 hours, 65 oocytes matured in 13 patients, which amounted to 42.5 % of oocytes without signs of degradation. In 11 patients the OCC was removed from the tumor-affected ovary. 149 oocytes were obtained, of which 50 (33.6 %) were oocytes with signs of degradation. The remaining 99 (66.4 %) of OCCs had satisfactory quality; after maturation, the Metaphase II stage reached in 49 (49.5 %) of oocytes. As a result, biological material was cryopreserved in 13 of 15 patients: 5 embryos and 60 oocytes.

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The authors declare that there are no conflicts of interest present.