Assisted Reproduction Unit, Clinical Institute of Gynecology, Obstetrics and Neonatology, Hospital Clinic de Barcelona, C/Villarroel 170, 08036, Barcelona, Spain.
August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
Clin Transl Oncol. 2024 May;26(5):1129-1138. doi: 10.1007/s12094-023-03330-2. Epub 2023 Oct 23.
Currently, 15% of gynaecological and 9% of haematological malignancies are diagnosed before the age of 40. The increased survival rates of cancer patients who are candidates for gonadotoxic treatments, the delay in childbearing to older ages, and the optimization of in vitro fertilisation techniques have all contributed to an increased interest in fertility preservation (FP) treatments. This study reviews the experience of the Fertility Preservation Programme (FPP) of a tertiary public hospital with a multidisciplinary approach.
This retrospective study included all the available (FP) treatments, performed in patients of childbearing age between 2006 and 2022.
1556 patients were referred to the FPP: 332 oocyte vitrification cycles, 115 ovarian cortex cryopreservation with 11 orthotopic autotransplantations, 175 gonadotropin-releasing hormone (GnRH) agonist treatments, 109 fertility-sparing treatments for gynaecological cancer, and 576 sperm cryopreservation were performed. Malignancy was the main indication for FP (the main indications being breast cancer in women and haematological malignancies in men), although non-oncological pathologies, such as endometriosis and autoimmune diseases, have increased in recent years. Currently, the most widely used FP technique is oocyte vitrification, the increase of which has been associated with a decrease in the use of cortex CP and GnRH agonists.
The increase in FP treatment reflects the implementation of reproductive counselling in oncology programmes. A multidisciplinary approach in a tertiary public hospital allows individualised FP treatment for each patient. In recent years, there has been a change in trend with the introduction of new indications for FP and a change in techniques due to their optimisation.
目前，15%的妇科恶性肿瘤和 9%的血液系统恶性肿瘤在 40 岁之前被诊断出来。癌症患者的生存率提高，这些患者适合性腺毒性治疗，生育年龄推迟到较晚的年龄，以及体外受精技术的优化，这些都导致人们对生育力保存（FP）治疗的兴趣增加。本研究回顾了一家三级公立医院多学科方法的生育力保存计划（FPP）的经验。
本回顾性研究包括 2006 年至 2022 年间所有可用于有生育能力的患者的（FP）治疗。
1556 名患者被转介到 FPP：332 个卵母细胞玻璃化冷冻循环，115 个卵巢皮质冷冻保存和 11 个原位自体移植，175 个促性腺激素释放激素（GnRH）激动剂治疗，109 个妇科癌症的生育保存治疗，和 576 个精子冷冻保存。恶性肿瘤是 FP 的主要指征（女性的主要指征是乳腺癌，男性是血液系统恶性肿瘤），尽管近年来非肿瘤性疾病，如子宫内膜异位症和自身免疫性疾病，有所增加。目前，最广泛使用的 FP 技术是卵母细胞玻璃化，其使用的增加与皮质 CP 和 GnRH 激动剂的使用减少有关。
FP 治疗的增加反映了在肿瘤计划中实施生殖咨询。在一家三级公立医院的多学科方法允许为每个患者提供个性化的 FP 治疗。近年来，随着 FP 新指征的引入和技术的优化，出现了一种趋势的变化。
