Dept of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; Obstet-Gynecol Dept, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Obstet-Gynecol Dept, San Raffaele Scientific Institute, IRCCS Milan, Italy.
Crit Rev Oncol Hematol. 2020 Oct;154:103092. doi: 10.1016/j.critrevonc.2020.103092. Epub 2020 Aug 27.
Fertility preservation in women with cervical cancer is a demanding but evolving issue. Some remarkable achievements have been reached, in particular the improvement of primary and secondary prevention and the broadening of the indications for conservative surgery up to FIGO 2018 stage IB2. Natural pregnancy rate and the rate of obstetrics complications following conservative approach is satisfactory even if not optimal. On the other hand, the use of classic strategies for fertility preservation such as oocytes or ovarian cortex freezing is extremely limited, being the uterus compromised by treatment in a high proportion of cases. In fact, the availability of uterine surrogacy can play a role in the counseling and the decision-making process. The recent advent of uterus transplantation is fascinating but, at present, cannot be viewed as a realistic solution.
宫颈癌患者的生育力保存是一个具有挑战性但不断发展的问题。已经取得了一些显著的成就，特别是在一级和二级预防方面的改善，以及将保守手术的适应证拓宽至 2018 年 FIGO 分期 IB2。即使不是最佳的，保守治疗后的自然妊娠率和产科并发症率也是令人满意的。另一方面，经典的生育力保存策略如卵子或卵巢皮质冷冻的应用非常有限，因为在大多数情况下，子宫因治疗而受到影响。事实上，子宫代孕的可用性可以在咨询和决策过程中发挥作用。最近子宫移植的出现令人着迷，但目前，它不能被视为一种现实的解决方案。
