Department of Obstetrics and Gynecology, Navy General Hospital, Beijing, China.
Int J Biol Sci. 2012;8(7):1005-12. doi: 10.7150/ijbs.4800. Epub 2012 Aug 1.
Advancements of diagnosis and treatment have substantially improved cancer survival rates in the last few decades. The increasing number of survivors focuses attention on long-term effects caused by cancer treatment and its impact on quality of life. Ovarian failure is one of the major sequelae of cytotoxic chemotherapy and/or radiotherapy in female children and reproductive-age women. Oncologists should address the patients about fertility preservation options before therapy. Embryo cryopreservation is the only well-established method for females in preserving fertility; however other strategies including ovarian suppression, ovarian transposition and cryopreservation of oocytes and ovarian tissue are still experimental. Patients need advice and to know which are the most practical options for them. This article reviews the available fertility preservation methods in women, and the related issues including normal physiology of the ovary, effect of anticancer therapy on fertility, role of the oncologist and ethics. We performed a MEDLINE search from 1971 to 2011 in a similar way as Jensen et al. 2011, using the following MeSH terms: antineoplastic agents; ovarian failure; premature; infertility, female; fertility preservation; child and cancer; reproductive technologies, assisted.
在过去几十年中,诊断和治疗的进步极大地提高了癌症患者的存活率。越来越多的幸存者将注意力集中在癌症治疗的长期影响及其对生活质量的影响上。卵巢衰竭是儿童和育龄女性接受细胞毒性化疗和/或放疗后的主要后遗症之一。肿瘤学家应在治疗前向患者说明生育力保存的选择。胚胎冷冻保存是女性保留生育力的唯一成熟方法;然而,其他策略,包括卵巢抑制、卵巢移位和卵母细胞和卵巢组织的冷冻保存,仍处于实验阶段。患者需要咨询并了解哪些是最适合他们的选择。本文综述了女性生育力保存的方法,以及相关问题,包括卵巢的正常生理学、抗癌治疗对生育力的影响、肿瘤学家的作用和伦理问题。我们以与 Jensen 等人 2011 年类似的方式,对 1971 年至 2011 年的 MEDLINE 进行了检索,使用的主题词是:抗肿瘤药;卵巢衰竭;早熟;女性不孕;生育力保存;儿童与癌症;辅助生殖技术。