Wyns C
Université Catholique de Louvain, Dept. of Gynecology and Andrology, Av. Hippocrate, 10, B-1200 Brussels, Belgium.
Facts Views Vis Obgyn. 2010;2(2):88-108.
Recent advances in cancer therapy have resulted in an increased number of long-term cancer survivors. Unfortunately, aggressive chemotherapy, radiotherapy and preparative regimens for bone marrow transplantation can severely affect male germ cells, including spermatogonial stem cells (SSCs), and lead to permanent loss of fertility. Different options for fertility preservation are dependent on the pubertal state of the patient.
Relevant studies were identified by an extensive Medline search of English and French language articles.
Sperm cryopreservation prior to gonadotoxic treatment is a well established method after puberty. In case of ejaculation failure by masturbation, assisted ejaculation methods or testicular tissue sampling should be considered. Although no effective gonadoprotective drug is yet available for in vivo spermatogonial stem cell (SSC) protection in humans, current evidence supports the feasibility of immature testicular tissue (ITT) cryopreservation. The different cryopreservation protocols and available fertility restoration options from frozen tissue, i.e. cell suspension transplantation, tissue grafting and in vitro maturation, are presented. RESULTS obtained in humans are discussed in the light of lessons learned from animal studies.
Advances in reproductive technology have made fertility preservation a real possibility in young patients whose gonadal function is threatened by gonadotoxic therapies. The putative indications for such techniques, as well as their limitations according to disease, are outlined.
癌症治疗的最新进展使长期癌症幸存者的数量有所增加。不幸的是，积极的化疗、放疗以及骨髓移植的预处理方案会严重影响男性生殖细胞，包括精原干细胞（SSCs），并导致永久性生育能力丧失。不同的生育力保存方法取决于患者的青春期状态。
通过广泛检索Medline数据库中英语和法语文章来确定相关研究。
青春期后，在进行性腺毒性治疗前进行精子冷冻保存是一种成熟的方法。如果手淫射精失败，应考虑采用辅助射精方法或睾丸组织取样。虽然目前尚无有效的性腺保护药物可用于体内保护人类精原干细胞（SSC），但现有证据支持冷冻保存未成熟睾丸组织（ITT）的可行性。本文介绍了不同的冷冻保存方案以及从冷冻组织恢复生育力的可用方法，即细胞悬液移植、组织移植和体外成熟。结合动物研究的经验教训，对人类获得的结果进行了讨论。
生殖技术的进步使生育力保存对于性腺功能受到性腺毒性治疗威胁的年轻患者成为现实可能。概述了此类技术的假定适应症及其根据疾病的局限性。
