人类卵巢皮质卵泡密度的年龄标准化参考值是否足以用于生育保护中的组织质量控制？已发表的关于样本没有已知卵巢病理的卵泡数量的定量数据被转换为皮质密度，以创建参考值。接下来，利用126名女孩（年龄为1-24岁，均值±标准差 11±6岁）的样本队列，这些女孩患有癌症、严重血液疾病或特纳综合征，以基于参考值的皮质卵泡密度计算Z-分数。未经治疗患者（0.3±3.5，n = 30）、接受烷化化疗（0.5±2.9，n=48）和未接受烷化化疗（0.1±1.3，n=6）的样本之间没有观察到差异。Z-分数与累积暴露于细胞毒性药物的剂量无关。然而，年轻接受治疗的患者（0-2岁，-2.1±3.1，n=10， P=0.04）的Z-分数明显低于年龄较大的接受治疗的患者（11-19岁，2±1.9，n=15）的Z-分数。特纳综合征患者的样本与未经治疗的患者的样本有显著差异（-5.2±5.1，n=24，P=0.003），并且-1.7的Z-分数被鉴定为用于识别卵巢储备减少的特纳综合征患者的良好诊断值。当将此阈值应用于其他患者时，分析显示，对于具有卵巢储备减少指征的患者（n=15），年龄显著更年轻（5.9±4.2与10.7±5.9岁，P=0.004），且未经治疗的患者更经常患非恶性血液疾病，而不是具有正常卵巢储备的患者（n=24，100%与19%，P=0.009）。Z-分数可用于估计用于生育保护的年轻患者皮质组织中卵泡密度的遗传和治疗相关效应。了解冷冻保存组织的质量有助于在患者咨询过程中使用。需要进一步研究该研究中发现的细胞毒性效应。版权所有©2023作者。由Elsevier Ltd.发表。保留所有权利。

Are age-normalized reference values for human ovarian cortical follicular density adequate for tissue quality control in fertility preservation?Published quantitative data on the number of follicles in samples without known ovarian pathology were converted into cortical densities to create reference values. Next, a sample cohort of 126 girls (age 1-24 years, mean ± SD 11 ± 6) with cancer, severe haematological disease or Turner syndrome were used to calculate Z-scores for cortical follicular density based on the reference values.No difference was observed between Z-scores in samples from untreated patients (0.3 ± 3.5, n = 30) and patients treated with (0.5 ± 2.9, n = 48) and without (0.1 ± 1.3, n = 6) alkylating chemotherapy. Z-scores were not correlated with increasing cumulative exposure to cytostatics. Nevertheless, Z-scores in young treated patients (0-2 years -2.1 ± 3.1, n = 10, P = 0.04) were significantly lower than Z-scores in older treated patients (11-19 years, 2 ± 1.9, n = 15). Samples from patients with Turner syndrome differed significantly from samples from untreated patients (-5.2 ± 5.1, n = 24, P = 0.003), and a Z-score of -1.7 was identified as a cut-off showing good diagnostic value for identification of patients with Turner syndrome with reduced ovarian reserve. When this cut-off was applied to other patients, analysis showed that those with indications for reduced ovarian reserve (n = 15) were significantly younger (5.9 ± 4.2 versus 10.7 ± 5.9 years, P = 0.004) and, when untreated, more often had non-malignant haematologic diseases compared with those with normal ovarian reserve (n = 24, 100% versus 19%, P = 0.009).Z-scores allow the estimation of genetic- and treatment-related effects on follicular density in cortical tissue from young patients stored for fertility preservation. Understanding the quality of cryopreserved tissue facilitates its use during patient counselling. More research is needed regarding the cytostatic effects found in this study.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.