Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Dept of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
Legal Counsultor for Health Human Rights, Law Firm Costantini, Rome, Italy.
Crit Rev Oncol Hematol. 2022 Mar;171:103604. doi: 10.1016/j.critrevonc.2022.103604. Epub 2022 Jan 25.
Hereditary cancer syndromes are a heterogeneous group of genetic conditions that are associated with an increased risk of developing cancer during lifespan. In affected women, parenthood may be accompanied by concerns for the offspring, considering the common autosomal dominant inheritance. Moreover, fertility preservation to prevent the detrimental effects of cancer treatments differs compared to other clinical contexts. The necessity to preserve gametes is indeed predictable and expected to be common. For these reasons, we advocate a personalized and early fertility counseling. Carriers should be aware of the risk of transmission. The possibility to perform elective oocytes cryopreservation, either before (previvors) or after (survivors) cancer diagnosis should be discussed. Finally, they should be informed about the options of preimplantation genetic test (PGT) and oocytes donation. In conclusion, physicians engaged in oncofertility should personalize the counseling for women with hereditary cancer syndromes, being aware of their peculiar needs.
遗传性癌症综合征是一组异质性的遗传疾病,这些疾病会增加患者在其一生中罹患癌症的风险。在受影响的女性中,由于常见的常染色体显性遗传,生育可能伴随着对后代的担忧。此外,与其他临床情况相比,为了预防癌症治疗的有害影响而进行生育力保存也有所不同。保存配子的必要性是可以预测的,而且预计会很常见。出于这些原因,我们提倡个性化和早期的生育咨询。携带者应该意识到传播的风险。应该讨论是否可以在癌症诊断之前(预先存在者)或之后(幸存者)选择进行卵母细胞冷冻保存。最后,应该告知他们关于植入前遗传学检测(PGT)和卵母细胞捐赠的选择。总之,从事肿瘤生育力医学的医生应该根据遗传性癌症综合征女性的具体情况来制定咨询计划,了解她们的特殊需求。