Rozati Hamoun, Handley Thomas, Jayasena Channa N
Section of Investigative Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK.
J Clin Med. 2017 Sep 19;6(9):89. doi: 10.3390/jcm6090089.
Sperm cryopreservation has been utilized routinely for over 40 years to preserve fertility in men undergoing cancer therapy and allow conception for infertile couples. This article provides a concise and up-to-date review of the literature and covers the latest advances in sperm cryopreservation and its array of clinical indications. Over recent years, the scope of clinical indications used for sperm cryopreservation has expanded widely. Consequently, more patient groups are eligible for sperm freezing, requiring specialist resources and higher running costs. Although sperm cryopreservation prior to cancer therapy is readily available in many countries, referral rates by oncology specialists and levels of patient engagement with cryopreservation services are both reported as low. Furthermore, sperm banking continues to raise ethical issues such whether sperm donation should be anonymous and whether sperm can be utilized posthumously by the surviving partner without consent from the patient. This review focuses on the technological advances and ethical controversies in sperm cryopreservation, and how better understanding of these issues could lead to improved access to fertility preserving treatment for patients.
精子冷冻保存已常规应用40多年,用于保护接受癌症治疗的男性的生育能力,并使不育夫妇能够受孕。本文对文献进行了简明且最新的综述,涵盖了精子冷冻保存的最新进展及其一系列临床适应症。近年来,用于精子冷冻保存的临床适应症范围已大幅扩大。因此,更多患者群体有资格进行精子冷冻,这需要专业资源且运营成本更高。尽管在许多国家,癌症治疗前的精子冷冻保存很容易获得,但据报道,肿瘤学专家的转诊率和患者对冷冻保存服务的参与度都很低。此外,精子库继续引发伦理问题,例如精子捐赠是否应该匿名,以及在未经患者同意的情况下,存活配偶是否可以在患者死后使用精子。本综述重点关注精子冷冻保存的技术进展和伦理争议,以及对这些问题的更好理解如何能够改善患者获得生育力保护治疗的机会。