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男性癌症患者的生育力保存。咨询与生殖结局。

Fertility preservation in male cancer patients. Counseling and reproductive outcomes.

作者信息

Kimelman Dana, Torrens Andrea, Bonelli Carla, Sapiro Rossana

机构信息

Oncofertility Program, Centro Hospitalario Pereira Rossell, Administración de los Servicios de Salud del Estado (ASSE), Montevideo, Uruguay.

Reprovita Lab and Biobank, Montevideo, Uruguay.

出版信息

Front Cell Dev Biol. 2023 Aug 16;11:1240152. doi: 10.3389/fcell.2023.1240152. eCollection 2023.

Abstract

Advances in cancer treatments have determined an increase in survival rates. However, these lifesaving therapies may have a negative impact on reproductive health. To diminish the infertility risk; different fertility preservation strategies have been designed. Sperm freezing is the gold standard fertility preservation method in the case of post-pubertal men. The main objective of this study is to evaluate the fertility status of Uruguayan male cancer survivors who have gone through sperm freezing, as well as to assess oncofertility counseling received by these patients. This is a descriptive, cross-sectional, observational, and transversal study. A survey was conducted on male cancer survivors who cryopreserved sperm between 1985 and 2021 in "Reprovita Lab and Biobank" which is the only sperm bank in this country. One hundred thirty-five participants answered the survey. At the time of diagnosis, the mean age of patients was 28.8 ± 6.4 years old. Testicular was the most frequent type of cancer (64%). Only, 12% ( = 15) already had children at the time of diagnosis. Among the interviewed survivors, 50% ( = 62) attempted to conceive after cancer treatment, and 68% ( = 42) achieved natural pregnancy. Patients who did not achieve spontaneous conception ( = 11), used their cryopreserved samples, and 45.4% achieved pregnancy. About 86% ( = 107) of survivors believed that the timing of oncofertility referrals was appropriate and 97% considered that having the possibility of protecting their fertility was very important. Eighty percent ( = 101), were advised by their attending physicians, 14% ( = 18) sought advice from family members or friends, and 4% ( = 5) from oncofertility specialists. To our knowledge, this is the first study evaluating the reproductive outcomes of male cancer survivors in our country and the region. Most of the interviewed survivors considered fertility preservation as a positive initiative, independent of their reproductive outcomes, reflecting the importance of fertility preservation counseling as one of the most important aspects for futurequality of life of young cancer patients.

摘要

癌症治疗的进展已使生存率有所提高。然而,这些挽救生命的疗法可能会对生殖健康产生负面影响。为降低不孕风险,人们设计了不同的生育力保存策略。对于青春期后的男性,精子冷冻是生育力保存的金标准方法。本研究的主要目的是评估接受过精子冷冻的乌拉圭男性癌症幸存者的生育状况,并评估这些患者接受的肿瘤生育咨询情况。这是一项描述性、横断面、观察性和横向研究。对1985年至2021年间在该国唯一的精子库“Reprovita实验室和生物样本库”冷冻精子的男性癌症幸存者进行了一项调查。135名参与者回答了该调查。在诊断时,患者的平均年龄为28.8±6.4岁。睾丸癌是最常见的癌症类型(64%)。只有12%(n = 15)在诊断时已经有孩子。在接受采访的幸存者中,50%(n = 62)在癌症治疗后尝试怀孕,68%(n = 42)实现了自然受孕。未实现自然受孕的患者(n = 11)使用了他们冷冻保存的样本,45.4%实现了怀孕。约86%(n = 107)的幸存者认为肿瘤生育转诊的时机合适,97%的人认为有保护生育力的可能性非常重要。80%(n = 101)是由他们的主治医生建议的,14%(n = 18)向家人或朋友寻求建议,4%(n = 5)向肿瘤生育专家寻求建议。据我们所知,这是我国和该地区第一项评估男性癌症幸存者生殖结局的研究。大多数接受采访的幸存者认为生育力保存是一项积极的举措,无论其生殖结局如何,这反映了生育力保存咨询作为年轻癌症患者未来生活质量最重要方面之一的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d436/10468982/6f8e92aeaa1f/fcell-11-1240152-g001.jpg

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