Fertility Preservation Strategies in Cancer Patients: A Comprehensive Review

Michał Razik, Piotr Bator, Patrycja Rozwadowska, Jan Ramian, Jakub Rybak, Barbara Magiera, Karol Magiera, Wiktor Razik
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Abstract

Introduction and purpose. Preserving fertility is crucial for cancer patients, aligning with advancements in oncology. As survival rates improve, addressing treatment-related late effects gains importance. Many young patients, aware of therapy toxicity, consider future conception chances, impacting treatment decisions. With a trend toward delayed childbirth and a growing population facing unplanned family planning disruptions, the demand for fertility preservation is expected to rise. This paper provides a brief review of available methods for preserving fertility in cancer patients.   State of knowledge. Freezing semen in liquid nitrogen vapor is a standard method for preserving reproductive potential in male cancer patients. Shielding during total-body radiation limits testicular volume reduction, indicating less damage to the germinal epithelium. Hormone suppression treatments are not protective in male cancer patients. Oocyte and embryo cryopreservation are considered secure methods before anticancer treatments, with oocyte cryopreservation being preferred for post-pubertal women. Ovarian tissue cryopreservation remains an alternative method without preliminary treatment, suitable when time is insufficient for ovarian stimulation. Ovarian transposition beyond the intended radiation area, performed laparoscopically, can retain ovarian function. GnRH agonist administration before and during chemotherapy aims to minimize the likelihood of premature ovarian insufficiency.   Summary. Advancements in fertility preservation for cancer patients, ranging from traditional cryopreservation to innovative methods like ovarian tissue preservation, highlight a commitment to empowering individuals facing cancer diagnoses. Ongoing research expands possibilities, ensuring a diverse range of strategies that offer tangible and hopeful prospects at the intersection of cancer and reproductive health.
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癌症患者的生育力保护策略:全面回顾
导言和目的。保持生育能力对癌症患者至关重要,这与肿瘤学的进步是一致的。随着生存率的提高,解决与治疗相关的晚期影响也变得越来越重要。许多年轻患者意识到治疗的毒性,会考虑未来的受孕机会,从而影响治疗决定。随着推迟生育的趋势和面临计划外计划生育干扰的人口不断增长,对生育力保存的需求预计将上升。本文简要回顾了现有的癌症患者生育力保存方法。知识现状。将精液冷冻在液氮蒸汽中是保存男性癌症患者生殖潜能的标准方法。全身放射治疗中的屏蔽可限制睾丸体积的缩小,这表明对生殖上皮的损伤较小。激素抑制治疗对男性癌症患者没有保护作用。卵母细胞和胚胎冷冻保存被认为是抗癌治疗前的安全方法,其中卵母细胞冷冻保存是青春期后妇女的首选。卵巢组织冷冻保存仍是一种无需前期治疗的替代方法,适用于卵巢刺激时间不足的情况。通过腹腔镜手术将卵巢移位到预定辐射区域之外,可以保留卵巢功能。在化疗前和化疗过程中使用 GnRH 促效剂,旨在将卵巢功能过早衰竭的可能性降至最低。总结。从传统的冷冻保存到卵巢组织保存等创新方法,癌症患者生育力保存方面的进步凸显了为面临癌症诊断的患者赋权的承诺。正在进行的研究拓展了各种可能性,确保在癌症与生殖健康的交汇点上,有一系列不同的策略提供切实而充满希望的前景。
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