Specchia Cristina, Baggiani Annamaria, Immediata Valentina, Ronchetti Camilla, Cesana Amalia, Smeraldi Antonella, Scaravelli Giulia, Levi-Setti Paolo Emanuele
Division of Gynaecology and Reproductive Medicine, Department of Gynaecology, Humanitas Fertility Center, Humanitas Clinical and Research Institute, Milan, Italy.
ART Italian National Register, National Centre for Epidemiology, Surveillance and Health Promotion, National Health Institute, Rome, Italy.
Front Endocrinol (Lausanne). 2019 Sep 3;10:600. doi: 10.3389/fendo.2019.00600. eCollection 2019.
The aim of the present study is to report our experience on elective women fertility preservation before cancer treatment. This is a single-center retrospective observational study, including all patients who underwent elective fertility preservation before oncological treatment between January 2001 and March 2019 at our Institute. Of a total of 568 women who received fertility counseling, 244 (42.9%) underwent 252 oocyte retrieval cycles after controlled ovarian stimulation for cryopreservation. The majority of patients were diagnosed with breast cancer (59.9%), followed by women affected by Hodgkin's and non-Hodgkin's lymphoma (27.4%). A minority comprised patients diagnosed with other malignancies that affected soft tissues (2.8%), ovary borderline type (2.4%), digestive system (1.6%), leukemia (1.6%), uterine cervix (1.2%). The remaining 3.1% were affected by other cancer types. The mean age of the cohort was 31.3 ± 6.4 years and the mean oocyte retrieval was 13.5± 8.4. Of 11 women who returned to attempt a pregnancy, three performed two thawed cycles. We obtained four pregnancies from 24 embryo transfers (Pregnancy Rate 36.4% for couple): two miscarriages and two live births. Overall, 95.7% of oocytes are still in storage. A close collaboration between Cancer and Fertility Center in a tertiary care hospital is essential to provide a good health service in oncological patients. Offering fertility preservation is no longer considered optional and must be included in every therapeutic program for women who receive an oncological diagnosis in their reproductive age. Oocyte cryopreservation appears to be a good opportunity for fertility preservation. Our results, although they are obtained in a small sample, are encouraging, even if only 4.5% of patients returned to use their gametes.
本研究的目的是报告我们在癌症治疗前对女性进行选择性生育力保存的经验。这是一项单中心回顾性观察研究，纳入了2001年1月至2019年3月在我们研究所接受肿瘤治疗前进行选择性生育力保存的所有患者。在总共568名接受生育咨询的女性中，244名（42.9%）在控制性卵巢刺激后进行了252个取卵周期用于冷冻保存。大多数患者被诊断为乳腺癌（59.9%），其次是受霍奇金淋巴瘤和非霍奇金淋巴瘤影响的女性（27.4%）。少数患者被诊断为其他影响软组织的恶性肿瘤（2.8%）、卵巢交界性肿瘤（2.4%）、消化系统肿瘤（1.6%）、白血病（1.6%）、子宫颈癌（1.2%）。其余3.1%受其他癌症类型影响。该队列的平均年龄为31.3±6.4岁，平均取卵数为13.5±8.4。在11名返回尝试怀孕的女性中，3名进行了两个解冻周期。我们从24次胚胎移植中获得了4次妊娠（夫妻妊娠率为36.4%）：2次流产和2次活产。总体而言，95.7%的卵母细胞仍在储存中。三级医院的癌症中心和生育中心之间密切合作对于为肿瘤患者提供良好的医疗服务至关重要。提供生育力保存不再被视为可选项，必须纳入每一位在育龄期被诊断为肿瘤的女性的治疗方案中。卵母细胞冷冻保存似乎是生育力保存的一个好机会。我们的结果虽然是在小样本中获得的，但令人鼓舞，尽管只有4.5%的患者返回使用她们的配子。
