自体精子冷冻保存对年轻男性癌症患者生育力保存的重要性及安全性
Importance and safety of autologous sperm cryopreservation for fertility preservation in young male patients with cancer.
作者信息
Li Yinfeng, Zhang Jian, Zhang Hanfeng, Liu Bo, Wang Guorong, Cao Maoqiu, Fu Bencui, Li Hui, Jiang Qinghua, Yu Lin, Xian Yang, Su Bizhen, Jiang Xiaohui
机构信息
Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China.
Department of Human Sperm Bank, West China Second University Hospital of Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
出版信息
Medicine (Baltimore). 2020 Apr;99(15):e19589. doi: 10.1097/MD.0000000000019589.
With development of tumor treatment, survival time of patients with cancer is significantly prolonged. Therefore, the current emphasis is not only the survival, but also the quality of life, especially, it is crucial for young male cancer patients who are unmarried and maintaining fertility. However, the awareness of fertility preservation for these patients is currently insufficient.To give physician and cancer patients more clear understanding of the importance and safety of sperm cryopreservation, so that achieve patient fertility benefits.First, the knowledge level and attitudes about fertility preservation were investigated by surveying 332 cancer patients and 103 medical staff with questionnaires. Second, 30 male cancer patients (experimental group) and 30 normal donors (control group) were selected and their sperm samples were cryopreserved. The sperm quality was compared between cancer patients and normal donors, before and after antitumor treatment in the cancer patients, and before and after sperm cryopreservation in both groups.In the questionnaire survey, we found that there were 70% to 80% of medical staffs and cancer patients lacked knowledge of fertility preservation, and 27.7% of patients worried that tumor and sperm cryopreservation might affect their offspring. In the sperm preservative experiment, we found that sperm quality in cancer patients was further damaged after radiotherapy/chemotherapy in addition to tumor itself had a negative effect. However, sperm deoxyribonucleic acid fragments were not affected by sperm cryopreservation although there were significant differences in sperm quality before and after sperm preservation in both groups.Radiotherapy/chemotherapy would further damage sperm quality of young male cancer patients. Medical staff should be aware of importance of sperm cryopreservation for fertility preservation for these patients. It is also necessary that medical staff should inform the patient about the safety of sperm freezing and guide the patient to participate in sperm cryopreservation.
随着肿瘤治疗的发展，癌症患者的生存时间显著延长。因此，当前不仅关注生存，还注重生活质量，特别是对于未婚且有生育需求的年轻男性癌症患者而言至关重要。然而，目前这些患者对生育力保存的认知不足。为了让医生和癌症患者更清楚地了解精子冷冻保存的重要性和安全性，从而实现患者的生育获益。首先，通过问卷调查332名癌症患者和103名医护人员，调查他们对生育力保存的知识水平和态度。其次，选取30名男性癌症患者（实验组）和30名正常供者（对照组），对他们的精子样本进行冷冻保存。比较癌症患者与正常供者之间、癌症患者抗肿瘤治疗前后以及两组精子冷冻保存前后的精子质量。在问卷调查中，我们发现70%至80%的医护人员和癌症患者缺乏生育力保存知识，27.7%的患者担心肿瘤和精子冷冻保存可能会影响其后代。在精子保存实验中，我们发现除肿瘤本身有负面影响外，癌症患者放疗/化疗后精子质量进一步受损。然而，尽管两组精子保存前后精子质量存在显著差异，但精子脱氧核糖核酸片段不受精子冷冻保存的影响。放疗/化疗会进一步损害年轻男性癌症患者的精子质量。医护人员应意识到精子冷冻保存对这些患者生育力保存的重要性。医护人员告知患者精子冷冻的安全性并指导患者参与精子冷冻保存也是必要的。
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