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男性癌症患者的生育力保存。

Fertility preservation in male patients with cancer.

机构信息

Assuta University Hospital, Ashdod, Israel; Division of Obstetrics and Gynecology, Ben-Gurion University of the Negev, Israel.

出版信息

Best Pract Res Clin Obstet Gynaecol. 2019 Feb;55:59-66. doi: 10.1016/j.bpobgyn.2018.12.004. Epub 2018 Dec 20.

Abstract

Advances in the treatment of cancer in young patients have led to great improvements in life expectancy, which currently approaches 80% 5-year survival rate. As a result, fertility preservation and desire for paternity have become a significant issue in this group. However, a major concern is the negative impact of chemotherapy, radiotherapy, and the malignancy itself on fertility. Thus, men about to have treatment for malignant conditions may have sperm cryopreserved before commencing chemotherapy or radiotherapy. Ejaculated sperm cryopreservation is the most common technique used. Some patients with cancer may present initially with oligospermia or azoospermia. In cases when a sample is not produced due to medical, social, or religious reasons, sperm can be retrieved using penile vibratory stimulation, electroejaculation, or testicular sperm extraction. Fertility preservation in prepubertal boys presents a great challenge, as sperm banking is not possible. Alternative strategies have been developed, but all are currently experimental.

摘要

在治疗年轻癌症患者方面的进展,使得患者的预期寿命得到了极大的提高,目前 5 年生存率接近 80%。因此,在这一群体中,生育力保存和生育意愿成为了一个重要问题。然而,一个主要的担忧是化疗、放疗和恶性肿瘤本身对生育力的负面影响。因此,即将接受恶性疾病治疗的男性可以在开始化疗或放疗前冷冻精子。目前最常用的技术是射出精液冷冻保存。一些患有癌症的患者最初可能表现为少精子症或无精子症。如果由于医学、社会或宗教原因无法提供样本,可以使用阴茎振动刺激、电刺激射精或睾丸精子提取来获取精子。对于青春期前的男孩来说,生育力保存是一个巨大的挑战,因为精子库是不可能的。已经开发了替代策略,但目前都还处于试验阶段。

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