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癌症患者的生育力保存(综述)。

Preservation of fertility in patients with cancer (Review).

机构信息

Department of Physiological Sciences, Physiology Unit, Faculty of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, IDIBELL, L'Hospitalet del Llobregat, 08907 Barcelona, Spain.

Department of Gynecology, Gynecological Endocrinology and Reproduction Unit, Hospital Universitari Sant Joan de Déu, Esplugues de Llobregat, 08950 Barcelona, Spain.

出版信息

Oncol Rep. 2019 May;41(5):2607-2614. doi: 10.3892/or.2019.7063. Epub 2019 Mar 14.

Abstract

Survival rates in oncological patients have been steadily increasing in recent years due to the greater effectiveness of novel oncological treatments, such as radio‑ and chemotherapy. However, these treatments impair the reproductive ability of patients, and may cause premature ovarian failure in females and azoospermia in males. Fertility preservation in both female and male oncological patients is nowadays possible and should be integrated as part of the oncological healthcare. The main objective of this review was to describe the different existing options of fertility preservation in patients undergoing gonadotoxic cancer treatments, as well as the differences in success rates that may appear in the different techniques evaluated. Emerging techniques are promising, such as the cryopreservation in orthotopic models of ovarian or testicle tissues, artificial ovaries, or in vitro culture prior to the autotransplantation of cryopreserved tissues. However, oocyte vitrification for female patients and sperm banking for male patients are considered the first line fertility preservation option at the present time for cancer patients undergoing treatment. Certainly, new fertility preservation techniques will continue to develop in the following years. However, despite the growing advances in the subject, optimal counselling from healthcare professionals should always be present.

摘要

近年来,由于新型肿瘤治疗方法(如放化疗)的效果更佳,肿瘤患者的生存率稳步提高。然而,这些治疗方法会损害患者的生殖能力,导致女性卵巢早衰和男性无精症。目前,对男女肿瘤患者进行生育力保存是可行的,应将其纳入肿瘤保健的一部分。本综述的主要目的是描述接受性腺毒性癌症治疗的患者中现有的不同生育力保存选择,以及评估的不同技术中可能出现的成功率差异。新兴技术很有前景,例如在卵巢或睾丸组织的原位模型中冷冻保存、人工卵巢,或在冷冻保存组织的自体移植前进行体外培养。然而,对于正在接受治疗的癌症患者,卵母细胞玻璃化冷冻保存被认为是女性患者的一线生育力保存选择,精子库则是男性患者的首选。当然,新的生育力保存技术在未来几年将继续发展。然而,尽管该领域取得了长足的进步,专业医疗保健人员的最佳咨询意见仍应始终存在。

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