New Promising Strategies in Oncofertility.

Janella N Hudson, Nathanael B Stanley, Leena Nahata, Meghan Bowman-Curci, Gwendolyn P Quinn
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Abstract

Introduction: Approximately 70,000 adolescent and young adults (AYA) are diagnosed with cancer each year. While advancements in treatment have led to improved prognosis and survival for patients, these same treatments can adversely affect AYA reproductive capacity. Localized treatments such as surgery and radiation therapy may affect fertility by removing or damaging reproductive organs, and systemic therapies such as chemotherapy can be toxic to gonads, (ovaries and testicles), thus affecting fertility and/or endocrine function. This can be traumatic for AYA with cancer as survivors often express desire to have genetic children and report feelings of regret or depression as a result of infertility caused by cancer treatments.

Areas covered: Emerging technologies in the field of assisted reproductive technology offer new promise for preserving the reproductive capacity of AYA cancer patients prior to treatment as well as providing alternatives for survivors. The following review revisits contemporary approaches to fertility preservation as well newly developing technologies.

Expert commentary: There are several advances in ART that hold promise for patients and survivors. However there are challenges that inhibit uptake including poor communication between providers and patients about risks and fertility preservation options; high costs; and lack of insurance coverage for fertility preservation services.

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肿瘤不孕不育领域前景广阔的新策略
导言:每年约有 7 万名青少年被诊断出患有癌症。虽然治疗方法的进步改善了患者的预后和存活率,但这些治疗方法也会对青少年的生育能力产生不利影响。手术和放疗等局部治疗可能会切除或损伤生殖器官,从而影响生育能力;化疗等全身治疗可能会对性腺(卵巢和睾丸)产生毒性作用,从而影响生育能力和/或内分泌功能。这可能对患癌症的青壮年患者造成创伤,因为幸存者往往表示希望拥有遗传子女,并表示因癌症治疗导致不育而感到遗憾或抑郁:辅助生殖技术领域的新兴技术为保护亚健康癌症患者在治疗前的生殖能力以及为幸存者提供替代方案提供了新的希望。下面的综述将重新审视当代的生育力保护方法以及新开发的技术:抗逆转录病毒疗法取得了多项进展,为患者和幸存者带来了希望。专家评论:抗逆转录病毒疗法的一些进展为患者和幸存者带来了希望,但也存在一些挑战,阻碍了这些技术的应用,包括医疗服务提供者与患者之间关于风险和生育力保存方案的沟通不畅、费用高昂以及生育力保存服务缺乏保险等。
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