Borini A, Rebellato E
Tecnobios Procreazione, Bologna, Italy.
Placenta. 2008 Oct;29 Suppl B:184-90. doi: 10.1016/j.placenta.2008.08.001.
In reproductive medicine the widespread use of ovarian stimulation has focused interest on the possible relation between induction of ovulation and breast and ovarian cancer. The epidemiological studies published so far are reassuring but not devoid of methodological problems, such as small populations, short follow-ups, and lack of information on confounding factors like oral contraceptive use. In younger patients to preserve fertility before radio- or chemotherapy, the American Society of Clinical Oncology recommended embryo cryopreservation as an established procedure. Moreover, experimental procedure as oocytes cryopreservation, ovarian suppression with GnRH analogues and cortical ovarian tissue freezing probably will be routinely used in the future. A reasonable proposal to protect patients from the risk of estrogen peaks in the case of estrogen receptor positive (ER+) breast cancer, ovarian stimulation with tamoxifen or letrozole could be right. Powered studies are necessary to control the safety and effectiveness of the different fertility preservation options. In this review we evaluated the relation between induction of ovulation and breast and ovarian cancer and then the possible options for fertility preservation in patients with these types of tumors.
在生殖医学中，卵巢刺激的广泛应用使人们关注排卵诱导与乳腺癌和卵巢癌之间的可能关系。迄今为止发表的流行病学研究结果令人安心，但并非没有方法学问题，如研究人群规模小、随访时间短，以及缺乏关于口服避孕药使用等混杂因素的信息。对于年轻患者，为在放疗或化疗前保留生育能力，美国临床肿瘤学会推荐胚胎冷冻保存作为一种既定方法。此外，诸如卵母细胞冷冻保存、使用促性腺激素释放激素类似物抑制卵巢以及卵巢皮质组织冷冻等实验性方法可能会在未来常规使用。对于雌激素受体阳性（ER+）乳腺癌患者，为保护其免受雌激素峰值风险，合理的建议是用他莫昔芬或来曲唑进行卵巢刺激。需要开展有足够样本量的研究来控制不同生育力保存方法的安全性和有效性。在本综述中，我们评估了排卵诱导与乳腺癌和卵巢癌之间的关系，然后探讨了这些类型肿瘤患者生育力保存的可能方法。
