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睾丸癌患者的生育力保存

Fertility preservation of patients with testicular cancer.

作者信息

Hamano Itsuto, Hatakeyama Shingo, Ohyama Chikara

机构信息

Department of Urology Hirosaki University Graduate School of Medicine Hirosaki Japan.

Department of Advanced Transplant and Regenerative Medicine Hirosaki University Graduate School of Medicine Hirosaki Japan.

出版信息

Reprod Med Biol. 2017 May 18;16(3):240-251. doi: 10.1002/rmb2.12037. eCollection 2017 Jul.

Abstract

BACKGROUND

Testicular cancer (TC) is one of the most common malignancies in young men of reproductive age. Although TC is a curable malignancy with a high survival rate, its treatment requires various cytotoxic modalities and negatively impacts spermatogenesis; therefore, the fertility preservation of patients with TC has been studied.

METHODS

In order to give an overview of fertility preservation in patients with TC, the literature was reviewed. Original and review articles were identified and examined on the basis of PubMed database searches.

RESULTS

Chemotherapy and radiotherapy damage spermatogenesis and retroperitoneal lymph node dissection negatively impacts ejaculatory function. Testicular sperm extraction facilitates successful sperm retrieval in patients with TC with postchemotherapy azoospermia. Although preserved sperm is used with a very low frequency (8%), the conception rates in those who have used sperm are not inferior.

CONCLUSION

The number of studies is limited, and because numerous treatment factors affect fertility, outstanding questions remain about preserving the fertility of patients with TC. Further studies are necessary in order to determine the best means of preventing and treating infertility in patients with TC.

摘要

背景

睾丸癌(TC)是育龄期年轻男性中最常见的恶性肿瘤之一。尽管睾丸癌是一种可治愈且生存率很高的恶性肿瘤,但其治疗需要多种细胞毒性治疗方式,并且会对精子发生产生负面影响;因此,对睾丸癌患者的生育力保存进行了研究。

方法

为了概述睾丸癌患者的生育力保存情况,对文献进行了综述。根据PubMed数据库搜索结果,识别并检查了原始文章和综述文章。

结果

化疗和放疗会损害精子发生,而腹膜后淋巴结清扫术会对射精功能产生负面影响。睾丸精子提取有助于化疗后无精子症的睾丸癌患者成功获取精子。尽管保存精子的使用频率非常低(8%),但使用精子的患者的受孕率并不低。

结论

研究数量有限,并且由于众多治疗因素会影响生育力,关于睾丸癌患者生育力保存仍存在诸多悬而未决的问题。有必要进一步开展研究,以确定预防和治疗睾丸癌患者不育症的最佳方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91a3/5715882/4ee2b9f6ed7e/RMB2-16-240-g001.jpg

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