Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Pediatric Oncology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan, Italy.
Fertil Steril. 2021 Oct;116(4):1087-1095. doi: 10.1016/j.fertnstert.2021.06.012. Epub 2021 Jul 5.
To assess the proportion of female childhood and adolescent tumor survivors who could benefit from oocyte cryopreservation.
Case series of female childhood and adolescent tumor survivors referred for fertility counseling.
A referral cancer center and an infertility unit of an academic hospital.
PATIENT(S): Young female childhood and adolescent tumor survivors who received gonadotoxic treatments.
INTERVENTION(S): Patients were prescribed tests of ovarian reserve and a personalized counseling was given. Oocyte cryopreservation was considered in subjects aged ≥18 years who were diagnosed with diminished ovarian reserve (DOR) (antimüllerian hormone level <2 ng/mL or total antral follicle count ≤10).
MAIN OUTCOME MEASURE(S): Rate of women with DOR who stored their oocytes.
RESULT(S): Ninety out of 126 evaluated women completed the assessments. We documented preserved ovarian reserve, DOR, and premature ovarian insufficiency in 36 (40%), 35 (39%), and 19 (21%) cases, respectively. Overall, 13 subjects with DOR were eligible for oocyte cryostorage, of whom 9 (69%) underwent the procedure. Considering the whole cohort of evaluated young women (n = 90), the rate of those who had egg freezing was 10%. Finally, nine women started seeking pregnancy after the counseling (six with DOR), and seven of them became pregnant. When the data were analyzed separately according to most gonadotoxic treatments, considerable differences emerged but the evidence did not support the idea that counseling should be restricted to particular subgroups of women.
CONCLUSION(S): Ovarian reserve impairment is common in female childhood and adolescent tumor survivors. Postcancer oocyte cryopreservation may be part of the armamentarium of fertility preservation options.
评估女性儿童和青少年肿瘤幸存者中能够受益于卵母细胞冷冻保存的比例。
对接受生育咨询的女性儿童和青少年肿瘤幸存者进行的病例系列研究。
一家癌症转诊中心和一家学术医院的不孕不育科。
接受性腺毒性治疗的年轻女性儿童和青少年肿瘤幸存者。
为患者开卵巢储备测试,并进行个性化咨询。年龄≥18 岁且被诊断为卵巢储备功能减退(DOR)(抗苗勒管激素水平<2ng/ml 或总窦卵泡计数≤10)的患者考虑进行卵母细胞冷冻保存。
患有 DOR 的女性进行卵母细胞冷冻保存的比例。
在 126 名接受评估的女性中,有 90 名完成了评估。我们分别记录了 36 例(40%)、35 例(39%)和 19 例(21%)的卵巢储备正常、DOR 和卵巢早衰。总的来说,13 例 DOR 患者有资格进行卵母细胞冷冻保存,其中 9 例(69%)接受了该程序。考虑到所有接受评估的年轻女性(n=90),进行卵子冷冻的比例为 10%。最后,9 名女性在咨询后开始寻求怀孕(6 例有 DOR),其中 7 例怀孕。当根据最常见的性腺毒性治疗分别分析数据时,出现了相当大的差异,但证据并不支持咨询应仅限于特定女性亚组的想法。
卵巢储备功能受损在女性儿童和青少年肿瘤幸存者中很常见。癌症后卵母细胞冷冻保存可能是生育保护选择的一部分。