Women's Hospital, Clinic for Gynecologic Endocrinology and Reproductive Medicine, University Hospital Basel, Basel, Switzerland.
Department of Gynecology and Obstetrics, Breast Center, SenoSuisse, Cantonal Hospital Winterthur, Winterthur, Switzerland.
Breast Cancer (Dove Med Press). 2014 Jul 17;6:93-101. doi: 10.2147/BCTT.S47234. eCollection 2014.
Invasive breast cancer (BC) is the most frequent cancer of young women. Considering the trend toward postponing childbearing until the later reproductive years, the number of childless women at diagnosis of BC will continue to increase. The American Society of Clinical Oncology and the American Society for Reproductive Medicine have recommended that the impact of cancer treatments on fertility should be addressed with all cancer patients of reproductive age and that options for fertility preservation, such as cryopreservation of embryos and oocytes, ovarian tissue, in vitro maturation of immature oocytes, and ovarian suppression with gonadotropin-releasing hormone analogs, should be discussed routinely. To optimally counsel patients on how to best weigh the risks and benefits of fertility preservation, both the health care provider and the patient must know about the options, their risks, and their likelihood of success. The aim of this review is to summarize current knowledge on fertility preservation options for young BC patients, surrogates of ovarian function, psychosocial aspects of infertility after cancer treatment, women's attitudes towards childbearing after cancer treatment, and health care providers' attitudes towards fertility preservation.
浸润性乳腺癌(BC)是年轻女性最常见的癌症。考虑到生育年龄推迟到生殖后期的趋势,诊断为 BC 的无子女女性人数将继续增加。美国临床肿瘤学会和美国生殖医学学会建议,所有育龄期癌症患者都应考虑癌症治疗对生育能力的影响,并应常规讨论生育力保存的选择,如胚胎和卵母细胞、卵巢组织的冷冻保存、不成熟卵母细胞的体外成熟以及促性腺激素释放激素类似物的卵巢抑制。为了为患者提供最佳建议,如何权衡生育力保存的风险和收益,医疗保健提供者和患者都必须了解这些选择、它们的风险以及成功的可能性。本综述的目的是总结年轻 BC 患者的生育力保存选择、卵巢功能替代物、癌症治疗后不孕的社会心理方面、女性对癌症治疗后生育的态度以及医疗保健提供者对生育力保存的态度。