Mitwally Mohamed F M
Canadian American Reproductive Medicine, Windsor, Ontario, Canada.
Expert Rev Anticancer Ther. 2007 Jul;7(7):989-1001. doi: 10.1586/14737140.7.7.989.
Recent advances in oncology have helped in the survival and cure of increasing numbers of childhood cancer patients and those during their reproductive age period. This has increased the need to improve existing technology, and prompted the search for new technologies, to minimize the gonadotoxic effects of cancer treatment and preserve human fertility. Conservative surgical approaches for cancer treatment have been widely accepted following progress in early detection of cancer and accumulating long-term outcome safety data. Gonadal suppression to increase resistance to cancer treatment by gonadotropin analogues and sex hormones has been suggested. However, while this is unlikely to be effective in males, there is no general consensus on its success in the female. Fertility preservation options for both male and female patients include cryopreservation of embryos, gametes and gonads. While embryo cryopreservation is a well-established and successful technique, there are several obvious limitations. Gamete cryopreservation is very successful in males (sperm freezing) while still experimental in females (oocyte freezing), with growing evidence suggesting its potential success. Gonadal cryopreservation is still in its early stages of experimental development, both in males (testicular tissue cryopreservation and in vitro spermatogenesis) and female (ovarian tissue cryopreservation and in vitro follicular maturation).
肿瘤学的最新进展有助于提高越来越多儿童癌症患者以及处于生育年龄阶段的癌症患者的生存率并实现治愈。这增加了改进现有技术的需求，并促使人们寻找新技术，以尽量减少癌症治疗对性腺的毒性作用并保护人类生育能力。随着癌症早期检测技术的进步以及长期疗效安全数据的积累，保守性手术治疗癌症的方法已被广泛接受。有人提出通过促性腺激素类似物和性激素进行性腺抑制，以增强对癌症治疗的耐受性。然而，虽然这对男性可能无效，但对于其在女性中的成功率尚无普遍共识。男性和女性患者的生育力保存选择包括胚胎、配子和性腺的冷冻保存。虽然胚胎冷冻保存是一项成熟且成功的技术，但存在一些明显的局限性。配子冷冻保存在男性（精子冷冻）中非常成功，而在女性（卵母细胞冷冻）中仍处于实验阶段，越来越多的证据表明其具有成功的潜力。性腺冷冻保存无论在男性（睾丸组织冷冻保存和体外精子发生）还是女性（卵巢组织冷冻保存和体外卵泡成熟）中都仍处于实验开发的早期阶段。
