Collins Gretchen, Patel Bansari, Thakore Suruchi, Liu James
From the Department of Reproductive Biology, Department of Gynecology, Case Western Reserve University, Cleveland, Ohio, and Department of Obstetrics and Gynecology, Wake Forest University, Winston-Salem, North Carolina.
South Med J. 2017 Mar;110(3):147-153. doi: 10.14423/SMJ.0000000000000611.
A potential consequence of chemotherapy is the destruction of oocytes, resulting in primary ovarian insufficiency (POI) in young patients; this often results in secondary amenorrhea and necessitates hormone replacement therapy. Regardless of the etiology of POI, the chance of pregnancy is low in this patient population. Given the extent to which oocyte depletion or dysfunction is variable, there is the possibility of spontaneous ovulation on hormone replacement therapy and subsequent pregnancy, however. If pregnancy is not desired, contraception always should be discussed. In most patients, the etiology of POI will not be known, but the treatment for all patients includes estrogen and progesterone therapy, which ensures the development of secondary sex characteristics, acquisition of peak bone mass, and promotion of uterine growth and maturation. Early diagnosis, patient education, and emotional support are important to mitigate long-term sequelae.
化疗的一个潜在后果是卵母细胞被破坏，导致年轻患者出现原发性卵巢功能不全（POI）；这通常会导致继发性闭经，需要进行激素替代疗法。无论POI的病因如何，该患者群体的怀孕几率都很低。然而，鉴于卵母细胞耗竭或功能障碍的程度存在差异，接受激素替代疗法的患者有可能自发排卵并随后怀孕。如果患者不想要怀孕，始终应讨论避孕措施。在大多数患者中，POI的病因尚不清楚，但所有患者的治疗都包括雌激素和孕激素疗法，这可确保第二性征的发育、获得峰值骨量以及促进子宫生长和成熟。早期诊断、患者教育和情感支持对于减轻长期后遗症很重要。
