Department of Clinical Hematology, Centro Hospitalar Universitário do Porto, Largo do Professor Abel Salazar, 4099-001 Porto, Portugal; UMIB-Unit for Multidisciplinary Research in Biomedicine/ITR-Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal.
Laboratory of Cell Biology, Department of Microscopy, ICBAS-School of Medicine and Biomedical Sciences, University of Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.
Blood Rev. 2023 Nov;62:101115. doi: 10.1016/j.blre.2023.101115. Epub 2023 Jul 13.
Recent developments of assisted reproduction techniques turned possible to avoid the infertility consequences of oncologic treatments, but fertility preservation (FP) has been somewhat neglected in women with hematologic diseases undergoing gonadotoxic treatments. For these specific cases, the current options for FP include the cryopreservation of embryos, mature oocytes and ovarian tissue, and oocyte in-vitro maturation. We intend to make patients and clinicians aware of this important and relevant issue, and provide hematologists, assisted reproduction physicians and patients, with updated tools to guide decisions for FP. The physicians of the units responsible for female FP should always be available to decide on the best-individualized FP option in strict collaboration with hematologists. With a wide range of options for FP tailored to each case, a greater level of training and information is needed among clinicians, so that patients proposed to gonadotoxic treatments can be previously advised for FP techniques in hematological conditions. ABBREVIATED ABSTRACT: Recent developments of assisted reproduction techniques turned possible to preserve the fertility of women with hematologic diseases undergoing gonadotoxic treatments. Current options for fertility preservation in women with hematologic diseases are presented. It is imperative to offer fertility preservation to all women before starting any gonadotoxic treatment and in some cases after treatment. Fertility preservation methods enable to later achieve the desired pregnancy.
近年来，辅助生殖技术的发展使得避免肿瘤治疗导致不孕的后果成为可能，但在接受性腺毒性治疗的血液疾病女性中，生育力保存（FP）多少有些被忽视。对于这些特殊情况，FP 的当前选择包括胚胎、成熟卵母细胞和卵巢组织以及卵母细胞体外成熟的冷冻保存。我们旨在使患者和临床医生意识到这个重要且相关的问题，并为血液学家、辅助生殖医生和患者提供更新的工具，以指导 FP 决策。负责女性 FP 的单位的医生应始终与血液学家密切合作，决定最佳的个体化 FP 方案。根据每个病例的情况，有广泛的 FP 选择，因此需要提高临床医生的培训和信息水平，以便在开始性腺毒性治疗之前，向患有血液疾病的患者提出 FP 技术建议。
辅助生殖技术的发展使得可以保留正在接受性腺毒性治疗的血液疾病女性的生育能力。本文介绍了血液疾病女性的 FP 选择。在开始任何性腺毒性治疗之前，在某些情况下在治疗后，为所有女性提供 FP 是至关重要的。FP 方法可以实现以后的妊娠愿望。
