Institute of Reproductive Medicine, Henan Provincial People's Hospital & People's Hospital of Zhengzhou University, Zhengzhou, Henan, PR China; Department of Gynaecology and Obstetrics, Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, PR China.
Department of Gynaecology and Obstetrics, Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, PR China.
Cancer Lett. 2019 Feb 1;442:148-160. doi: 10.1016/j.canlet.2018.10.023. Epub 2018 Oct 30.
Continuous improvement in diagnosis and treatment has significantly increased the survival of cancer patients. Treatments for neoplastic disease, including radiotherapy, chemotherapy, and surgery or combined therapy with the above methods, may lead to premature ovarian insufficiency (POI) or substantial male germ cell loss. For the patients it is a seriously double whammy. Therefore, reproductive medicine experts strongly suggest that all young patients diagnosed with a malignant tumor should immediately undergo a consultation with suggestions for fertility and endocrine function protection and preservation. Here, we discuss the background knowledge, methods, indications, pros and cons, and experimental and clinical applications of fertility preservation, and new strategies for future fertility conservation to help physicians, especially oncologist, pediatrician, hematologist, and surgeons, become aware of the concepts, methods, and importance of fertility and endocrine function protection. We also hope to help doctors develop novel personalized strategies for fertility conservation according to patients' own conditions, tumor types, treatment methods, recurrence rate and so on. This review focuses on changing and enhancing the fertility preservation idea, further investigations in clinical and translational medicine will help ensure the development of novel personalized treatments, to help cancer patients have healthy children or maintain endocrine function once they are in remission. This is just the ultimate dream of oncofertility.
不断提高的诊断和治疗水平显著提高了癌症患者的生存率。针对肿瘤疾病的治疗，包括放疗、化疗、手术或上述方法的联合治疗，可能导致卵巢早衰（POI）或大量男性生殖细胞损失。这对患者来说是双重打击。因此，生殖医学专家强烈建议所有被诊断患有恶性肿瘤的年轻患者都应立即进行生育咨询，并提出保护和保存生育和内分泌功能的建议。在这里，我们讨论了生育力保存的背景知识、方法、适应证、优缺点以及实验和临床应用，并探讨了未来生育保存的新策略，以帮助医生，尤其是肿瘤学家、儿科医生、血液学家和外科医生，了解生育和内分泌功能保护的概念、方法和重要性。我们还希望帮助医生根据患者自身情况、肿瘤类型、治疗方法、复发率等制定新的个性化生育保护策略。这篇综述重点讨论了改变和增强生育保护理念，进一步的临床和转化医学研究将有助于确保新的个性化治疗方法的发展，帮助癌症患者在缓解后拥有健康的孩子或维持内分泌功能。这正是肿瘤生育学的终极梦想。
