Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
Department of Obstetrics and Gynecology, Erasmus MC-University Medical Center, Rotterdam, the Netherlands.
J Pediatr Adolesc Gynecol. 2022 Oct;35(5):523-526. doi: 10.1016/j.jpag.2022.03.005. Epub 2022 Mar 28.
Infertility is a serious early, as well as late, effect of childhood cancer treatment. If addressed in a timely manner at diagnosis, fertility preservation measures can be taken, preferably before the start of cancer treatment. However, pediatric oncologists might remain reluctant to offer counseling on fertility-preservation methods, although infrastructure to freeze ovarian tissue has become available and is currently considered standard care for pre- and postpubertal girls at high risk of gonadal damage. More importantly, risk factors have been identified for cancer treatment-related impairment of gonadal function, and the first successful pregnancies have been reported after autotransplanted ovarian tissue, which has been harvested from children. Additionally, great progress has been made in the field of ex vivo maturation of oocytes in frozen ovarian tissue, which provides opportunities for those at risk of ovarian micrometastasis. Hence, it is time to counsel girls at risk and make every effort to cryopreserve their ovarian tissue, now more than ever before.
不孕是儿童癌症治疗的一个严重的早期和晚期效应。如果在诊断时及时采取生育力保存措施，最好在癌症治疗开始之前，就可以做到这一点。然而，儿科肿瘤学家可能仍然不愿意提供关于生育力保存方法的咨询，尽管冷冻卵巢组织的基础设施已经可用，目前被认为是高风险性腺损伤的青春期前和青春期后女孩的标准护理。更重要的是，已经确定了与癌症治疗相关的性腺功能障碍的风险因素，并且在从儿童中采集的自体移植卵巢组织后已经报告了首例成功怀孕的案例。此外，在冷冻卵巢组织中卵母细胞的体外成熟领域取得了巨大进展，为那些有卵巢微转移风险的人提供了机会。因此，现在是时候为有风险的女孩提供咨询，并尽一切努力冷冻保存她们的卵巢组织了，这比以往任何时候都更为重要。
