Oktay Kutluk, Sönmezer Murat
Department of Obstetrics and Gynecology, Joan and Sanford I. Weill Medical College of Cornell University, New York, NY 10021, USA.
Curr Opin Oncol. 2007 Sep;19(5):506-11. doi: 10.1097/CCO.0b013e3282a14eae.
This review focuses on the current options for fertility preservation in young women facing the risk of premature ovarian failure and infertility as a sequel to the treatment of gynecologic cancer.
There is a wide range of options to preserve fertility. Embryo freezing is the most established method and the success rate of in-vitro fertilization using frozen-thawed embryos now approaches that of using fresh embryos. Success rates with oocyte cryopreservation are on the rise and begin to approach that of embryo freezing. Exposure to high levels of estrogen during ovarian stimulation can be minimized by utilizing aromatase inhibitors in women with estrogen-sensitive cancers undergoing embryo or oocyte cryopreservation. Ovarian-tissue cryopreservation is used to preserve fertility in children and in patients with time restraints; however, the number of reported cases is very small. Likewise, in-vitro maturation and xenografting are experimental and their potential to preserve fertility remains to be determined.
A number of fertility-preservation techniques have been developed and many others are in the experimental stages. Consistent with recent ASCO clinical guidelines, all young individuals with gynecologic cancer should be counseled about the available fertility preservation techniques.
本综述聚焦于面临卵巢早衰风险以及因妇科癌症治疗而导致不孕的年轻女性目前的生育力保存选择。
有多种生育力保存方法。胚胎冷冻是最成熟的方法，使用冻融胚胎的体外受精成功率目前已接近使用新鲜胚胎的成功率。卵母细胞冷冻保存的成功率正在上升，并开始接近胚胎冷冻的成功率。对于接受胚胎或卵母细胞冷冻保存的雌激素敏感型癌症女性，使用芳香化酶抑制剂可将卵巢刺激期间高雌激素暴露降至最低。卵巢组织冷冻保存用于儿童及时间紧迫的患者的生育力保存；然而，报道的病例数量非常少。同样，体外成熟和异种移植仍处于实验阶段，其生育力保存潜力有待确定。
已开发出多种生育力保存技术，其他许多技术仍处于实验阶段。与美国临床肿瘤学会（ASCO）近期临床指南一致，所有患有妇科癌症的年轻个体都应接受关于可用生育力保存技术的咨询。
