Bringer-Deutsch S, Belaisch-Allart J, Delvigne A
Centre hospitalier des Quatre Villes, Service de gynécologie-obstétrique et médecine de la reproduction, Site de Sèvres, 141 Grande Rue, 92318 Sèvres, France.
J Gynecol Obstet Biol Reprod (Paris). 2010 Dec;39(8 Suppl 2):S53-66. doi: 10.1016/S0368-2315(10)70031-4.
The different options of fertility preservation must be approached with all patients before initiating any cancer therapy and physicians should refer each patient treated during their reproductive years to specialists in a specialized center that will evaluate the best available alternatives to preserve male and female fertility.The only efficiently proven ways of fertility preservation are sperm cryopreservation for men and embryo cryopreservation to preserve couple fertility. However, the recent progress observed with oocyte cryopreservation (in particular the oocyte vitrification) may change our practices in the future if vitrification is allowed in France. Although the law of Bioethics of 2004 authorizes the ovarian cryopreservation today, its modalities of use stay at present at the stage of the research. But in spite of the low number of published births today in France and in the world, the ovarian tissue cryopreservation is a promising technique. It remains the last possible alternative to protect fertility of prepubertal girls. The sperm cryopreservation must be systematically proposed to all men (even teenagers) undergoing a treatment for cancer potentially harmful for their fertility whatever their sperm quality. The testicular tissue cryopreservation is also a method to be discussed for adults, teenagers in case of failure of sperm banking or for prepubertal boys.
在开始任何癌症治疗之前，必须与所有患者探讨不同的生育力保存方案，并且医生应将每位在生育年龄接受治疗的患者转介至专业中心的专家处，这些专家将评估保存男性和女性生育力的最佳可用方案。唯一经有效证实的生育力保存方法是男性精子冷冻保存以及为保存夫妻生育力进行胚胎冷冻保存。然而，如果法国允许卵母细胞玻璃化冷冻，那么最近在卵母细胞冷冻保存（尤其是卵母细胞玻璃化冷冻）方面取得的进展可能会在未来改变我们的做法。尽管2004年的生物伦理法如今已批准卵巢冷冻保存，但其使用方式目前仍处于研究阶段。不过，尽管目前法国乃至全世界已公布的通过卵巢组织冷冻保存后出生的案例数量较少，但卵巢组织冷冻保存仍是一项有前景的技术。它仍然是保护青春期前女孩生育力的最后一种可能选择。对于所有接受可能对其生育力有害的癌症治疗的男性（甚至青少年），无论其精子质量如何，都必须系统地建议他们进行精子冷冻保存。对于成年人、精子库保存失败的青少年或青春期前男孩，睾丸组织冷冻保存也是一种有待探讨的方法。
