Departamento de Obstetricia, Ginecología y Medicina de Reproducción, Institut Universitari Dexeus, Universitat Autònoma de Barcelona, Barcelona, Spain.
Gynecol Endocrinol. 2013 Apr;29(4):285-91. doi: 10.3109/09513590.2012.743019. Epub 2013 Jan 24.
Improvements in early diagnosis and treatment strategies in cancer patients have enabled younger women with cancer to survive. In addition to the stressful event of the diagnosis, patients with malignant diseases face the potential loss of the opportunity to have children. Preservation of fertility has become a challenging issue and it is still surrounded by controversies. On the basis of available evidence, a group of experts reached a consensus regarding the options for trying to preserve fertility in women with cancer: among established methods, in postpubertal women, oocyte cryopreservation is the preferred option, whereas ovarian tissue cryopreservation is the only possibility for prepubertal girls. Combining several strategies on an individual basis may improve the chances of success. Realistic information should be provided before any intervention is initiated. Counseling should offer support for patients and provide better care by understanding emotional needs, psychological predictors of distress and methods of coping. Early referral to the fertility specialist is essential as fertility preservation (FP) may improve quality of life in these patients. The information summarized here is intended to help specialists involved in the treatment of cancer and reproductive medicine to improve their understanding of procedures available for FP in young cancer patients.
癌症患者的早期诊断和治疗策略的改进使年轻的癌症女性得以存活。除了诊断这一压力事件外,恶性疾病患者还面临着失去生育机会的潜在风险。生育力的保存已成为一个具有挑战性的问题,并且仍然存在争议。基于现有证据,一组专家就癌症患者尝试保留生育力的选择达成了共识:在已确立的方法中,对于青春期后的女性,卵母细胞冷冻保存是首选方法,而对于青春期前的女孩,卵巢组织冷冻保存是唯一的选择。在个体基础上结合多种策略可能会提高成功的机会。在开始任何干预措施之前,应提供现实的信息。咨询应通过了解情感需求、困扰的心理预测因素和应对方法为患者提供支持,并提供更好的护理。早期向生育专家转介至关重要,因为生育力保存(FP)可以提高这些患者的生活质量。这里总结的信息旨在帮助参与癌症治疗和生殖医学的专家更好地了解年轻癌症患者的 FP 可用程序。