De Vos Michel, Smitz Johan, Woodruff Teresa K
Centre for Reproductive Medicine, UZ Brussel, Brussels, Belgium.
Laboratory of Clinical Chemistry and Radioimmunology, UZ Brussel, Brussels, Belgium.
Lancet. 2014 Oct 4;384(9950):1302-10. doi: 10.1016/S0140-6736(14)60834-5.
Enhanced long-term survival rates of young women with cancer and advances in reproductive medicine and cryobiology have culminated in an increased interest in fertility preservation methods in girls and young women with cancer. Present data suggest that young patients with cancer should be referred for fertility preservation counselling quickly to help with their coping process. Although the clinical application of novel developments, including oocyte vitrification and oocyte maturation in vitro, has resulted in reasonable success rates in assisted reproduction programmes, experience with these techniques in the setting of fertility preservation is in its infancy. It is hoped that these and other approaches, some of which are still regarded as experimental (eg, ovarian tissue cryopreservation, pharmacological protection against gonadotoxic agents, in-vitro follicle growth, and follicle transplantation) will be optimised and become established within the next decade. Unravelling the complex mechanisms of activation and suppression of follicle growth will not only expand the care of thousands of women diagnosed with cancer, but also inform the care of millions of women confronted with reduced reproductive fitness because of ageing.
癌症年轻女性长期生存率的提高以及生殖医学和低温生物学的进展，使得人们对癌症女童和年轻女性的生育力保存方法越来越感兴趣。目前的数据表明，癌症年轻患者应尽快接受生育力保存咨询，以帮助他们应对这一过程。尽管包括卵母细胞玻璃化和体外卵母细胞成熟在内的新进展在辅助生殖计划中已取得了合理的成功率，但这些技术在生育力保存方面的经验仍处于起步阶段。希望这些方法以及其他一些方法（其中一些仍被视为实验性方法，如卵巢组织冷冻保存、针对性腺毒性药物的药理保护、体外卵泡生长和卵泡移植）在未来十年内能够得到优化并确立下来。揭示卵泡生长激活和抑制的复杂机制不仅将扩大对数以千计被诊断患有癌症的女性的护理范围，还将为因衰老而生殖健康下降的数百万女性的护理提供参考。
