Sanada Yuko, Harada Miyuki, Kunitomi Chisato, Kanatani Mayuko, Izumi Gentaro, Hirata Tetsuya, Fujii Tomoyuki, Suzuki Nao, Morishige Ken-Ichirou, Aoki Daisuke, Irahara Minoru, Tsugawa Koichiro, Tanimoto Mitsune, Nishiyama Hiroyuki, Hosoi Hajime, Sugiyama Kazuhiko, Kawai Akira, Osuga Yutaka
Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kawasaki, Japan.
J Obstet Gynaecol Res. 2019 Oct;45(10):2021-2028. doi: 10.1111/jog.14073. Epub 2019 Jul 30.
The survival rates of cancer patients have greatly improved owing to the advances in oncology. The preservation of fertility in cancer patients is an important task. To determine the reality of cryopreservation of embryos, oocytes and ovarian tissue in cancer patients, large-scale survey analysis was performed in Japan.
We sent 613 Japan Society of Obstetrics and Gynecology-certified assisted reproductive technology institutions a questionnaire about their experience of performing cryopreservation for cancer patients between January 2011 and December 2015. Subsequently, the institutions that conducted cryopreservation for cancer patients were sent a second questionnaire.
We received replies from 481 (78.5%) institutions. Among them, 126 (26.2%) conducted cryopreservation for cancer patients. These 126 institutions were sent a second questionnaire. Of these, 108 (85.7%) institutions responded. At the 108 institutions, 1085 embryo or oocyte cryopreservation procedures and 122 ovarian tissue cryopreservation procedures were conducted for cancer patients. Cryopreservation was mainly performed for breast cancer patients (~70%), followed by patients with hematological malignancy. A total of 361 and 19 embryo transfer cycles were performed for patients whose embryos and oocytes were cryopreserved, respectively, and 42 and seven institutions reported pregnancy outcomes after embryo transfer in patients that underwent embryo and oocyte cryopreservation, respectively. However, pregnancy was not observed in the seven cases that underwent ovarian tissue transfer.
Indications, age limits and ovarian stimulation protocols for cryopreservation widely varied between the institutions. A national registration system for oncofertility must be established to evaluate the safety and efficacy of the current system.
由于肿瘤学的进展，癌症患者的生存率有了显著提高。保留癌症患者的生育能力是一项重要任务。为了确定癌症患者胚胎、卵母细胞和卵巢组织冷冻保存的实际情况，在日本进行了大规模调查分析。
我们向613家日本妇产科学会认证的辅助生殖技术机构发送了一份关于2011年1月至2015年12月期间为癌症患者进行冷冻保存经验的调查问卷。随后，向为癌症患者进行冷冻保存的机构发送了第二份调查问卷。
我们收到了481家（78.5%）机构的回复。其中，126家（26.2%）为癌症患者进行了冷冻保存。这126家机构收到了第二份调查问卷。其中，108家（85.7%）机构做出了回应。在这108家机构中，为癌症患者进行了1085例胚胎或卵母细胞冷冻保存程序以及122例卵巢组织冷冻保存程序。冷冻保存主要针对乳腺癌患者（约70%），其次是血液系统恶性肿瘤患者。分别为胚胎和卵母细胞被冷冻保存的患者进行了361次和19次胚胎移植周期，分别有42家和7家机构报告了胚胎和卵母细胞冷冻保存患者胚胎移植后的妊娠结局。然而，在7例接受卵巢组织移植的病例中未观察到妊娠。
各机构之间冷冻保存的适应症、年龄限制和卵巢刺激方案差异很大。必须建立一个全国性的肿瘤生育登记系统，以评估当前系统的安全性和有效性。
