Department of Gynecological Endocrinology and Reproductive Medicine, Innsbruck Medical University, A-6020 Innsbruck, Austria.
Ann Oncol. 2013 Mar;24(3):598-608. doi: 10.1093/annonc/mds514. Epub 2012 Nov 4.
Ovarian aging and cytotoxic treatments are the most common causes for fertility loss in women. With increasing numbers of young female survivors following cytotoxic cancer treatments, the issue of fertility preservation has assumed greater importance.
We review the literature on the causes of female fertility loss as well as the recent advances in fertility preservation options and strategies that might be of interest to oncologists. Currently, several methods and techniques exist for fertility preservation of female patients with cancer including embryo freezing, ovarian protection techniques, oocyte cryopreservation, ovarian tissue cryopreservation followed by autotransplantation, and recently in vitro culture of ovarian tissue, follicles, and oocytes. Each method or technique has advantages and disadvantages related to current success rate, required delay in cancer treatment, sperm requirement, and risk of reintroducing cancer cells.
To date, embryo freezing is the only established method successfully and widely used for fertility preservation of female patients with cancer. The other methods are promising but still considered experimental.
Patient awareness, physician knowledge, early counseling, costs management, international registry, interdisciplinary networks, and research development are necessary to improve the current care in the field of female fertility preservation.
卵巢衰老和细胞毒性治疗是女性生育力丧失的最常见原因。随着接受细胞毒性癌症治疗的年轻女性幸存者人数的增加，生育力保存问题变得更加重要。
我们回顾了有关女性生育力丧失原因的文献，以及最近在生育力保存选择和策略方面的进展，这些可能对肿瘤学家感兴趣。目前，有几种方法和技术可用于保存患有癌症的女性患者的生育能力，包括胚胎冷冻、卵巢保护技术、卵母细胞冷冻保存、卵巢组织冷冻保存后自体移植，以及最近的卵巢组织、卵泡和卵母细胞体外培养。每种方法或技术都有其优缺点，与当前的成功率、癌症治疗的延迟、精子需求以及重新引入癌细胞的风险有关。
迄今为止，胚胎冷冻是唯一成功且广泛应用于癌症女性患者生育力保存的方法。其他方法很有前途，但仍被认为是实验性的。
提高女性生育力保存领域的当前护理水平，需要患者意识、医生知识、早期咨询、成本管理、国际登记、跨学科网络和研究发展。
