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巴西癌症女性患者的生育力保存:不孕不育专家的认知和态度。

Fertility preservation in female cancer patients in Brazil: perceptions and attitudes of infertility specialists.

机构信息

Universidade Estadual Paulista "Júlio de Mesquita Filho" Faculdade de Medicina de Botucatu Department of Gynecology BotucatuSP Brazil Department of Gynecology, Obstetrics and Mastology, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil.

Universidade Federal de Minas Gerais Department of Gynecology and Obstetrics Belo HorizonteMG Brazil Department of Gynecology and Obstetrics, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

出版信息

Rev Bras Ginecol Obstet. 2024 Apr 9;46. doi: 10.61622/rbgo/2024rbgo25. eCollection 2024.

Abstract

OBJECTIVE

Fertility preservation is a priority in oncology for female cancer patients. However, there is a lack of communication between infertility specialists and oncologists. This study aimed to evaluate infertility specialists' perceptions and experiences regarding fertility preservation.

METHODS

Conduct an online survey to profile infertility specialists. Participants were infertility affiliated with the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO). The specialists received an online survey, which response rate were 30.9%, most of whom were in southern and southeastern. The survey consisted on 14 questions about the infertility specialists' location, techniques in clinical practice, treatment successful rate, patients idea, etc.

RESULTS

The average experience in human reproduction were 15.5 ± 10.2 years (mean ± standard deviation, range 1-40). Among reproductive-aged female cancer patients recommended for fertility preservation, 60.3 ± 28.8% (range 10-100%) underwent preservation procedures. Main barriers were cost (41%), oncologists' knowledge or acceptance (35%) and accessibility (9%). Most infertility specialists (58%) considered 40 years the limit for fertility preservation. Leukemia, lymphoma, breast and ovarian cancers were prioritized for fertility preservation, while lung, thyroid, gastric, and brain cancers were less relevant.

CONCLUSION

This is the first Brazilian study about infertility specialists' perceptions on oncology patients access to fertility preservation. These patients primarily receive treatment in the public health system, while infertility specialists mainly work in the private healthcare. This healthcare mode is currently fragmented, but integrating these experts is enhancing patient access to fertility preservation. Studies on this topic are still warranted.

摘要

目的

生育力保存是女性癌症患者肿瘤学的首要任务。然而,不孕专家和肿瘤学家之间缺乏沟通。本研究旨在评估不孕专家对生育力保存的看法和经验。

方法

进行在线调查以了解不孕专家的概况。参与者隶属于巴西妇产学联合会(FEBRASGO)的不孕专科。专家们收到了一份在线调查,回复率为 30.9%,其中大多数来自南部和东南部。该调查包括 14 个问题,涉及不孕专家的位置、临床实践中的技术、治疗成功率、患者的想法等。

结果

人类生殖的平均经验为 15.5 ± 10.2 年(平均值 ± 标准差,范围 1-40)。在推荐进行生育力保存的生殖期女性癌症患者中,60.3 ± 28.8%(范围 10-100%)接受了保存程序。主要障碍是费用(41%)、肿瘤学家的知识或接受度(35%)和可及性(9%)。大多数不孕专家(58%)认为 40 岁是生育力保存的极限。白血病、淋巴瘤、乳腺癌和卵巢癌是生育力保存的优先考虑对象,而肺癌、甲状腺癌、胃癌和脑癌则不太相关。

结论

这是巴西第一项关于不孕专家对肿瘤患者获得生育力保存看法的研究。这些患者主要在公共卫生系统接受治疗,而不孕专家主要在私营医疗保健系统工作。这种医疗保健模式目前是分散的,但整合这些专家正在增强患者获得生育力保存的机会。仍需要对此类问题进行研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f849/11075391/05204839c204/1806-9339-rbgo-46-e-rbgo25-gf01.jpg

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