Chao H T, Wang P H, Yuan C C, Lee W L
Department of Obstetrics and Gynecology, Veterans General Hospital, Taipei, Taiwan.
J Reprod Med. 1998 Aug;43(8):703-6.
Although radiotherapy is an integral part of managing certain types of hematologic malignancies, its effect on the reproductive system are well established. We report a case of successful pregnancy in a patient who received high-dose whole-body irradiation (WBI) (1,575 cGy) as part of her treatment for acute myeloid leukemia (AML).
A 26-year-old woman received high-dose cyclophosphamide accompanied by high-dose (1,575 cGy) WBI as part of her treatment for AML when she was 23 years of age. The patient received oral contraceptives before, during and after treatment. After WBI, the patient developed ovarian failure and amenorrhea, which was confirmed by hormonal evaluation. The amenorrhea persisted for one year. No recurrence of AML was found. The patient was placed on hormone replacement therapy (HRT) because of vasomotor changes. An unexpected pregnancy occurred 14 months later; HRT was discontinued. The patient delivered a normal female infant at 38 weeks of gestation. The infant was followed for eight months; her development appeared to be normal.
In this case report, it is unclear whether pregnancy resulted from active folliculogenesis remote from radiation therapy or from possible ovarian protection rendered by the use of oral contraceptives. The benefit of oral contraceptives in protecting the ovary from radiation injury is unknown and remains an area for future research.
尽管放射治疗是某些血液系统恶性肿瘤治疗的重要组成部分，但其对生殖系统的影响已得到充分证实。我们报告了一例在接受高剂量全身照射（WBI）（1575 厘戈瑞）作为急性髓系白血病（AML）治疗一部分的患者中成功怀孕的病例。
一名 26 岁女性在 23 岁时接受高剂量环磷酰胺联合高剂量（1575 厘戈瑞）WBI 作为 AML 治疗的一部分。患者在治疗前、治疗期间和治疗后均服用口服避孕药。WBI 后，患者出现卵巢功能衰竭和闭经，激素评估证实了这一点。闭经持续了一年。未发现 AML 复发。由于血管舒缩变化，患者接受了激素替代疗法（HRT）。14 个月后意外怀孕；停用了 HRT。患者在妊娠 38 周时分娩了一名正常女婴。对婴儿进行了八个月的随访；其发育似乎正常。
在本病例报告中，尚不清楚怀孕是由于远离放射治疗的活跃卵泡生成还是由于使用口服避孕药可能提供的卵巢保护。口服避孕药在保护卵巢免受辐射损伤方面的益处尚不清楚，仍是未来研究的一个领域。
