Levine Jennifer M
Division of Pediatric Hematology, Oncology and Stem Cell Transplant, Columbia University Medical Center, 161 Fort Washington Avenue, IP-7, New York, NY 10032, USA.
Children (Basel). 2014 Aug 26;1(2):166-85. doi: 10.3390/children1020166.
In the face of excellent survival rates for pediatric and adolescent cancer, preserving the opportunity to have biological children is an important component of long term quality of life. Yet, modern chemotherapeutic regimens continue to pose a threat to fertility. The only fertility preservation methods available to pre-pubertal children of both genders is cryopreservation of gonadal tissue, a highly experimental intervention, or shielding/re-location of reproductive tissue in the setting of radiation. These techniques are available in the post pubertal population as well, but post pubertal patients also have the option for cryopreservation of gametes, a process that is much simpler in males than females. For this reason, prior to the initiation of therapy, sperm banking should be considered standard of care for males, while consideration of embryo or oocyte cryopreservation should be limited to those females at risk of developing ovarian failure. Attention to reproductive health and fertility preservation should continue after the completion of therapy. Establishing programs that streamline access to current fertility preservation techniques will assist in ensuring that all eligible patients can avail themselves of current options.
面对儿童和青少年癌症的高生存率，保留生育亲生孩子的机会是长期生活质量的一个重要组成部分。然而，现代化疗方案仍然对生育能力构成威胁。对于青春期前的男女儿童，现有的唯一生育力保存方法是冷冻保存性腺组织（一种高度试验性的干预措施），或在放疗时对生殖组织进行屏蔽/移位。这些技术在青春期后的人群中也可用，但青春期后的患者也可以选择冷冻保存配子，这一过程在男性中比在女性中要简单得多。因此，在开始治疗前，精子库保存应被视为男性的标准治疗措施，而胚胎或卵母细胞冷冻保存应仅限于有发生卵巢功能衰竭风险的女性。治疗结束后仍应关注生殖健康和生育力保存。建立简化现有生育力保存技术获取途径的项目将有助于确保所有符合条件的患者都能利用现有的选择。
