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单中心女性癌症患者生育力保存结局。

Outcomes of Fertility Preservation for Female Cancer Patients in a Single Tertiary Center.

机构信息

Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Yonsei Med J. 2023 Aug;64(8):497-504. doi: 10.3349/ymj.2023.0009.

Abstract

PURPOSE

To report our experience of fertility preservation (FP) in female cancer patients.

MATERIALS AND METHODS

We retrospectively analyzed the medical records of female who underwent elective oocyte or embryo cryopreservation before cancer treatment between January 2015 and December 2020 at Asan Medical Center. We analyzed the type of cancer, the rate of reuse of cryopreserved oocytes or embryos, and fertility outcomes such as the resumption of menstruation or pregnancy.

RESULTS

A total of 174 patients underwent 182 oocyte retrieval cycles after controlled ovarian stimulation for oocyte or embryo cryopreservation. The median age of patients was 33.0 (range 19-46) years, and the patients were most unmarried female (65.52%). The majority of patients were diagnosed with breast cancer (78.16%), and the remaining were diagnosed with gastrointestinal (6.33%) and hematologic malignancies (5.75%). The maturation rate of oocyte cryopreservation was 83.33%, and the fertilization rate of embryo cryopreservation was 72.07%. Of the 57 patients currently not undergoing cancer treatment, 34 resumed menstruating and 19 (33.33%, 19/57) returned to attempt a pregnancy. Among them, five patients succeeded in natural pregnancy. Eleven patients received frozen-thawed embryo transfer, and four patients succeeded in becoming pregnant (36.36%, 4/11). Only 6.3% of patients returned to use their gametes, and 93.7% of gametes are still in storage.

CONCLUSION

FP in cancer patients should be considered before cancer treatment. Through continuous research on oncofertility, it is necessary to consider how to increase the return rate and provide appropriate information to cancer patients of reproductive age.

摘要

目的

报告我们在女性癌症患者中进行生育力保存(FP)的经验。

材料与方法

我们回顾性分析了 2015 年 1 月至 2020 年 12 月期间在 Asan 医疗中心接受癌症治疗前选择性卵母细胞或胚胎冷冻保存的女性患者的病历。我们分析了癌症的类型、冷冻保存卵母细胞或胚胎的再利用率以及生育结局,如月经恢复或妊娠。

结果

共有 174 例患者接受了控制性卵巢刺激后的 182 个卵母细胞回收周期,用于卵母细胞或胚胎冷冻保存。患者的中位年龄为 33.0(19-46)岁,大多数为未婚女性(65.52%)。大多数患者被诊断为乳腺癌(78.16%),其余患者被诊断为胃肠道(6.33%)和血液恶性肿瘤(5.75%)。卵母细胞冷冻保存的成熟率为 83.33%,胚胎冷冻保存的受精率为 72.07%。在目前未接受癌症治疗的 57 例患者中,34 例恢复了月经,19 例(33.33%,19/57)返回尝试妊娠。其中,5 例患者自然妊娠成功。11 例患者接受了冷冻解冻胚胎移植,4 例患者妊娠成功(36.36%,4/11)。仅有 6.3%的患者返回使用其配子,93.7%的配子仍在储存中。

结论

应在癌症治疗前考虑癌症患者的 FP。通过对oncofertility 的持续研究,有必要考虑如何提高返回率,并向育龄癌症患者提供适当的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f66a/10375243/3501e03c90b9/ymj-64-497-g001.jpg

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