Department of Obstetrics and Gynecology, Pritzker School of Medicine, University of Chicago, Chicago, Illinois;
InVia Fertility Specialists, Chicago, Illinois.
Pediatrics. 2020 Mar;145(3). doi: 10.1542/peds.2019-3994. Epub 2020 Feb 18.
Many cancers presenting in children and adolescents are curable with surgery, chemotherapy, and/or radiotherapy. Potential adverse consequences of treatment include sterility, infertility, or subfertility as a result of gonad removal, damage to germ cells as a result of adjuvant therapy, or damage to the pituitary and hypothalamus or uterus as a result of irradiation. In recent years, treatment of solid tumors and hematologic malignancies has been modified in an attempt to reduce damage to the gonadal axis. Simultaneously, advances in assisted reproductive technology have led to new possibilities for the prevention and treatment of infertility. This clinical report reviews the medical aspects and ethical considerations that arise when considering fertility preservation in pediatric and adolescent patients with cancer.
许多儿童和青少年癌症可以通过手术、化疗和/或放疗治愈。治疗的潜在不良后果包括因性腺切除导致的不育、不孕或生育力降低，辅助治疗导致生殖细胞受损，或因放疗导致垂体和下丘脑或子宫受损。近年来，为了减少对性腺轴的损害，实体瘤和血液恶性肿瘤的治疗方法已经得到了修改。同时，辅助生殖技术的进步也为预防和治疗不孕不育带来了新的可能。本临床报告回顾了在考虑癌症患儿和青少年生育力保存时出现的医学方面和伦理方面的问题。
