Chang Katherine, Merideth Melissa A, Stratton Pamela
Department of Obstetrics and Gynecology, Northwestern Memorial Hospital, Chicago, Illinois; and the Medical Genetics Branch, National Human Genome Research Institute, and the Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
Obstet Gynecol. 2015 Oct;126(4):779-784. doi: 10.1097/AOG.0000000000001031.
There is a growing population of women who have or will undergo hematopoietic stem cell transplant for a variety of malignant and benign conditions. Gynecologists play an important role in addressing the gynecologic and reproductive health concerns for these women throughout the transplant process. As women undergo cell transplantation, they should avoid becoming pregnant and are at risk of uterine bleeding. Thus, counseling about and implementing hormonal treatments such as gonadotropin-releasing hormone agonists, combined hormonal contraceptives, and progestin-only methods help to achieve therapeutic amenorrhea and can serve as contraception during the peritransplant period. In this commentary, we summarize the timing, risks, and benefits of the hormonal options just before, during, and for the year after hematopoietic stem cell transplantation.
越来越多的女性因各种恶性和良性疾病已经或将要接受造血干细胞移植。在整个移植过程中,妇科医生在解决这些女性的妇科和生殖健康问题方面发挥着重要作用。随着女性接受细胞移植,她们应避免怀孕且有子宫出血的风险。因此,关于促性腺激素释放激素激动剂、复方激素避孕药和仅含孕激素方法等激素治疗的咨询和实施,有助于实现治疗性闭经,并可在移植期间用作避孕措施。在这篇评论中,我们总结了造血干细胞移植前、移植期间及移植后一年激素选择的时机、风险和益处。