Chatterjee R, Kottaridis P D
Department of Obstetrics, University College London Medical School, London, UK.
Bone Marrow Transplant. 2002 Nov;30(10):629-35. doi: 10.1038/sj.bmt.1703721.
Management of iatrogenic gonadal reproductive failure and sexual morbidity assumes a priority, especially in young recipients of high-dose chemotherapy and stem cell transplantation (SCT). Hormone replacement treatment (HRT) is beneficial for correction of sexual symptoms and osteoporosis in both sexes, especially in females. Sperm banking is the standard technique for preservation of fertility in adult and sexually mature adolescent males. Testicular tissue cryopreservation has a place in well-selected azoospermic adults and in mentally and sexually competent adolescents. In vitro fertilisation using superovulation with embryo-cryopreservation (for future embryo transfer) is the most tried method in female SCT recipients with good results. In mentally and sexually competent adolescents and adults without a partner, ovarian cortical tissue cryopreservation has a place for subsequent re-implantation to orthotopic or heterotopic sites. Gonadotrophin releasing hormone (GnRH) co-treatment during chemotherapy, is a promising method for the future. Although generally reassuring, continued monitoring of the offspring of SCT survivors and follow-up of all recipients of SCT is important for return of spontaneous or induced fertility.
医源性性腺生殖功能衰竭和性疾病的管理至关重要，特别是对于接受高剂量化疗和干细胞移植（SCT）的年轻患者。激素替代疗法（HRT）对纠正男女两性的性症状和骨质疏松有益，尤其是对女性。精子库是成年和性成熟青少年男性保存生育能力的标准技术。睾丸组织冷冻保存适用于精心挑选的无精子症成年患者以及心理和性能力正常的青少年。对于女性SCT受者，使用超排卵结合胚胎冷冻保存（以备将来胚胎移植）的体外受精是最常用的方法，效果良好。对于没有伴侣的心理和性能力正常的青少年及成年人，卵巢皮质组织冷冻保存可用于随后将其重新植入原位或异位。化疗期间联合使用促性腺激素释放激素（GnRH）是未来一种有前景的方法。尽管总体上令人放心，但持续监测SCT幸存者的后代以及对所有SCT受者进行随访对于恢复自然或诱导生育能力很重要。
