Moores Cancer Center, University of California San Diego, San Diego, CA, USA.
Department of Obstetrics and Gynecology, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
Reprod Sci. 2021 Jun;28(6):1746-1758. doi: 10.1007/s43032-021-00517-2. Epub 2021 Mar 31.
Although advances in cancer treatment and early diagnosis have significantly improved cancer survival rates, cancer therapies can cause serious side effects, including ovarian failure and infertility, in women of reproductive age. Infertility following cancer treatment can have significant adverse effects on the quality of life. However, established methods for fertility preservation, including embryo or oocyte cryopreservation, are not always suitable for female cancer patients because of complicated individual conditions and treatment methods. Ovarian tissue cryopreservation and transplantation is a promising option for fertility preservation in pre-pubertal girls and adult patients with cancer who require immediate treatment, or who are not eligible to undergo ovarian stimulation. This review introduces various methods and strategies to improve ovarian tissue cryopreservation and transplantation outcomes, to help patients and clinicians choose the best option when considering the potential complexity of a patient's situation. Effective multidisciplinary oncofertility strategies, involving the inclusion of a highly skilled and experienced oncofertility team that considers cryopreservation methods, thawing processes and devices, surgical procedures for transplantation, and advances in technologies, are necessary to provide high-quality care to a cancer patient.
尽管癌症治疗和早期诊断的进展显著提高了癌症患者的生存率,但癌症治疗会导致女性生育期患者出现严重的副作用,包括卵巢功能衰竭和不孕。癌症治疗后导致的不孕会对生活质量产生重大的负面影响。然而,由于个体情况和治疗方法复杂,包括胚胎或卵母细胞冷冻保存在内的既定生育力保存方法并不总是适用于女性癌症患者。对于需要立即治疗或不适合进行卵巢刺激的青春期前女孩和患有癌症的成年患者,卵巢组织冷冻保存和移植是一种很有前途的生育力保存选择。本综述介绍了各种方法和策略,以提高卵巢组织冷冻保存和移植的效果,帮助患者和临床医生在考虑患者情况的潜在复杂性时,选择最佳方案。有效的多学科肿瘤生育策略,包括纳入一个高度熟练和经验丰富的肿瘤生育团队,该团队会考虑冷冻保存方法、解冻过程和设备、移植的手术程序以及技术的进步,对于向癌症患者提供高质量的护理是必要的。