Garrido-Oyarzún M F, Castelo-Branco C
a Clínica Universidad de los Andes, Department of Obstetrics & Gynecology and Reproductive Biology, Faculty of Medicine , Universidad de los Andes , Santiago , Chile.
b Clinic Institute of Gynecology, Obstetrics and Neonatology , Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona , Barcelona , Spain.
Climacteric. 2016 Dec;19(6):522-525. doi: 10.1080/13697137.2016.1225713. Epub 2016 Sep 17.
The increase in cancer incidence in younger people and the significant improvement in long and permanent remission have brought concern about their reproductive future and quality of life. Up to two-thirds of adult female patients undergoing chemotherapy for malignancies eventually develop premature ovarian failure. This condition is related to many complaints including vasomotor symptoms, osteoporosis, increased risk of cardiovascular diseases, sexual dysfunction, and infertility. Therefore, protection against iatrogenic infertility and loss of endocrine ovarian function caused by chemotherapy is currently of high priority. Several options have been used for preserving ovarian function. Established methods include cryopreservation of embryos and/or ova, and ovarian transposition, while others such as ovarian tissue preservation are new, yet promising treatments for fertility preservation. The administration of gonadotropin releasing hormone (GnRH) agonistic analogs (GnRH-a) is still considered experimental. However, the recent evidence is strong to recommend the use of GnRH-a co-treatment during chemotherapy in young women with cancer to protect ovarian function, with promising results regarding fertility preservation. As the use of GnRH-a is non-invasive, highly available and without impact on cancer treatment outcomes, it should be offered to all young female cancer patients to preserve their ovarian function.
年轻人癌症发病率的上升以及长期和永久缓解的显著改善引发了人们对他们生殖未来和生活质量的关注。接受恶性肿瘤化疗的成年女性患者中，高达三分之二最终会出现卵巢早衰。这种情况与许多症状有关，包括血管舒缩症状、骨质疏松、心血管疾病风险增加、性功能障碍和不孕。因此，目前高度优先的是预防化疗引起的医源性不孕和卵巢内分泌功能丧失。已经有几种方法用于保护卵巢功能。既定的方法包括胚胎和/或卵子的冷冻保存以及卵巢移位，而其他方法如卵巢组织保存是用于生育力保护的新的、但有前景的治疗方法。促性腺激素释放激素（GnRH）激动剂类似物（GnRH-a）的给药仍被认为是实验性的。然而，最近的证据有力地推荐在患有癌症的年轻女性化疗期间使用GnRH-a联合治疗以保护卵巢功能，在生育力保护方面取得了有前景的结果。由于GnRH-a的使用是非侵入性的、易于获得且不影响癌症治疗结果，应该为所有年轻女性癌症患者提供以保护她们的卵巢功能。
