Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Kingdom of Saudi Arabia.
Semin Oncol. 2020 Dec;47(6):390-397. doi: 10.1053/j.seminoncol.2020.09.003. Epub 2020 Oct 23.
Refinement of therapies continues to improve the prognosis and survival of cancer patients. However, women of reproductive age face a risk of premature ovarian failure due to the gonadotoxicity of aggressive oncological treatment, which may also be used to treat other nonmalignant disorders. Development of cryobiology and assisted reproduction has allowed fertility preservation, which is increasingly requested, and can also aid fertility in iatrogenic and noniatrogenic conditions. Established protocols including embryo and oocyte freezing are only performed for adult women; however, ovarian tissue cryopreservation is an approach that can also assist prepubertal girls. Medical fertility cryopreservation for females has been recently legalized in Saudi Arabia. However, prior to implementing the service in clinical practice in Saudi Arabia, guidelines on patient selection criteria and adequate staff training are essential. Moreover, worldwide registry data and the findings of long-term studies involving many patients on the safety of ovarian tissue freezing are required to conclusively establish medical fertility cryopreservation as a safe procedure. Progress can be achieved in oncofertility by improving and optimizing techniques that include immature oocyte growth and maturation and artificial ovary development.
治疗方法的不断完善，提高了癌症患者的预后和生存率。然而，处于生育年龄的女性由于侵袭性肿瘤治疗的性腺毒性，面临着卵巢早衰的风险，这种治疗也可能用于治疗其他非恶性疾病。冷冻生物学和辅助生殖技术的发展，使得生育力保存成为可能，并且越来越受到人们的需求，也可以帮助医源性和非医源性不孕患者。包括胚胎和卵母细胞冷冻在内的既定方案仅适用于成年女性；然而，卵巢组织冷冻保存也是一种可以帮助青春期前女孩的方法。沙特阿拉伯最近已经将女性的生育力冷冻保存合法化。然而，在沙特阿拉伯的临床实践中实施该服务之前，制定关于患者选择标准和充足的员工培训的指南是必不可少的。此外，还需要全球注册数据和涉及许多患者的长期研究结果，以明确确定卵巢组织冷冻作为一种安全的程序。通过改进和优化包括未成熟卵母细胞生长和成熟以及人工卵巢发育等技术，可以在肿瘤生育力方面取得进展。
