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应对医源性绝经。波兰的生育力保存计划——单中心经验。

Challenging iatrogenic menopause. Oncofertility programme in Poland - a single-centre experience.

作者信息

Horbaczewska Anna, Jach Robert, Zmaczyński Andrzej, Kacalska-Janssen Olga, Doroszewska Katarzyna, Piróg Magdalena, Kabzińska-Turek Monika

机构信息

Clinic of Gynaecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland.

Clinic of Gynaecological Oncology, Jagiellonian University Medical College, Krakow, Poland.

出版信息

Prz Menopauzalny. 2019 Jun;18(2):63-67. doi: 10.5114/pm.2019.85787. Epub 2019 Jun 14.

Abstract

INTRODUCTION

Menopause is defined as a 12-month period of time when menstruation permanently ceases. In some cases, menopause may be caused by external factors - for example gonadotoxic treatment that irreversibly damages ovarian tissue leading to loss of its hormonal and reproductive function. Oncofertility is a discipline that merges oncology and reproductive medicine, giving patients a chance to experience parenthood after gonadotoxic treatment is finished.

AIM OF THE STUDY

The purpose of the study is to present the implementation and first outcomes of the Oncofertility Programme in the University Clinic of Endocrinological Gynaecology and Gynaecology, University Hospital in Krakow, Poland.

MATERIAL AND METHODS

Patients interested in fertility preservation have been consulted in the University Clinic of Endocrinological Gynaecology and Gynaecology in Krakow since April 2016. Preliminary qualification to one of the available methods (embryo cryopreservation, oocyte cryopreservation, ovarian tissue cryopreservation) was conducted. Patients declaring a wish to join the programme were then referred to one of the three infertility treatment centres cooperating with the University Clinic, in order to undergo the chosen procedure.

RESULTS

During a period of 24 months, 18 patients were consulted. The youngest consulted patient was 20 years old, the oldest 39. Two years after the first consultation, a telephone survey among consulted patients was carried out to verify whether the patients finally underwent oncofertility procedures, and to ask about their reproductive status.

CONCLUSIONS

The problem of fertility issues being inadequately addressed results in low referral rates to oncofertility programmes. Attempts to raise awareness of oncofertility possibilities among oncologists should be undertaken because critically few patients are being referred to oncofertility centres.

摘要

引言

更年期被定义为月经永久性停止的连续12个月时间段。在某些情况下,更年期可能由外部因素引起,例如性腺毒性治疗,这种治疗会不可逆转地损害卵巢组织,导致其激素和生殖功能丧失。肿瘤生育学是一门融合肿瘤学和生殖医学的学科,使患者在性腺毒性治疗结束后有机会成为父母。

研究目的

本研究的目的是介绍波兰克拉科夫大学医院内分泌妇科和妇科大学诊所肿瘤生育计划的实施情况和初步成果。

材料与方法

自2016年4月以来,对有生育力保存意愿的患者在克拉科夫内分泌妇科和妇科大学诊所进行了咨询。对可用方法(胚胎冷冻保存、卵母细胞冷冻保存、卵巢组织冷冻保存)之一进行了初步资格评估。然后,宣布希望加入该计划的患者被转介到与大学诊所合作的三个不孕治疗中心之一,以接受所选程序。

结果

在24个月的时间里,有18名患者接受了咨询。接受咨询的最年轻患者为20岁,最年长为39岁。首次咨询两年后,对接受咨询的患者进行了电话调查,以核实患者最终是否接受了肿瘤生育程序,并询问他们的生殖状况。

结论

生育问题未得到充分解决,导致转介到肿瘤生育计划的比例较低。由于转介到肿瘤生育中心的患者极少,因此应努力提高肿瘤学家对肿瘤生育可能性的认识。

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