Clinica e Investigacion en Ginecologia y Obstetricia最新文献_第4页

Impacto del uso de redes sociales en las gestantes del área norte de Madrid 使用社交网络对马德里北部地区孕妇的影响

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Clinica e Investigacion en Ginecologia y Obstetricia

Pub Date : 2025-04-01 Epub Date: 2025-01-11 DOI: 10.1016/j.gine.2024.101030

N. Mateos-Canals, S. Ruiz-Martínez, N. Martínez Sánchez, J.L. Bartha Rasero, M.C. Fernández-Miranda

Objective

To evaluate the use of social media (SM) and its impact on pregnant women in the northern area of Madrid, Spain.

Method

An anonymous survey was conducted with 231 pregnant women who were monitored in the Obstetrics Service of La Paz University Hospital (Madrid). The use of various SM platforms and the information sought were evaluated, as well as the perceived credibility, influence on attitudes, and effects on perceived anxiety following their use.

Results

97% of pregnant women used SM, with 83.5% using it daily. Usage was higher among younger age groups, with Instagram being the most used SM platform. 81.7% of them followed profiles related to obstetrics/perinatal care, but one in five was unaware of the professionalism of the person behind the profile. Information about pregnancy, childbirth, neonatal care, and breastfeeding were the most sought-after topics, with an increase in the search for breastfeeding information among younger women. 45.4% considered the information to be highly credible, and 49.3% believed it could moderately influence their attitudes. Finally, 47.4% reported feeling moderately calm with the information, and 51.2% experienced low levels of anxiety.

Conclusions

The use of SM among pregnant women reflects that of the general population, with Instagram being the most popular platform. Many patients seek medical information on SM but often verify it with healthcare professionals. The credibility of information on SM varies, having a moderate influence on attitudes and perceived anxiety.

目的了解西班牙马德里北部地区孕妇使用社交媒体的情况及其影响。方法对马德里拉巴斯大学医院产科监测的231例孕妇进行匿名调查。评估了各种SM平台的使用情况和所寻求的信息，以及使用这些平台后感知到的可信度、对态度的影响以及对感知到的焦虑的影响。结果97%的孕妇使用过SM， 83.5%的孕妇每日使用。年轻群体的使用率更高，Instagram是最常用的SM平台。其中81.7%的人关注与产科/围产期护理相关的资料，但五分之一的人不知道资料背后的人的专业性。有关怀孕、分娩、新生儿护理和母乳喂养的信息是最受欢迎的话题，年轻女性对母乳喂养信息的搜索有所增加。45.4%的人认为信息高度可信，49.3%的人认为信息会适度影响他们的态度。最后，47.4%的人表示对这些信息感到适度平静，51.2%的人感到低水平的焦虑。结论孕妇使用SM反映了一般人群的使用情况，Instagram是最受欢迎的平台。许多患者寻求关于性行为的医疗信息，但往往向医疗保健专业人员求证。SM信息的可信度存在差异，对态度和感知焦虑有中等程度的影响。

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引用次数: 0

Women empowerment and its impact on fertility 妇女赋权及其对生育率的影响

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Clinica e Investigacion en Ginecologia y Obstetricia

Pub Date : 2025-01-01 Epub Date: 2024-11-29 DOI: 10.1016/j.gine.2024.101017

J. Puerta Suárez , S.M. Vélez Cuervo , W.D. Cardona Maya

引用次数: 0

Descripción de un caso: liposarcoma de mama radioinducido 病例报告：放射性诱导的乳腺脂肪肉瘤

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Clinica e Investigacion en Ginecologia y Obstetricia

Pub Date : 2025-01-01 Epub Date: 2024-09-30 DOI: 10.1016/j.gine.2024.100998

M.I. Limia Pérez , J.A. Moreno Domingo , L. Juez González , M.J. Fernández Mellado , S. Ajuriagogeaskoa , L. Muñoz Arberas , A. Urones Goikoetxea

Main symptoms and/or clinical findings

Breast sarcoma is a very rare entity that constitutes only 1% of all primary malignant breast tumors. It has a very poor prognosis with a high risk of recurrence. In this article, we present the case of a patient diagnosed with breast liposarcoma after having received radiotherapy for a previous breast carcinoma.

Main diagnoses

Due to the rarity of breast liposarcoma, it is important to make an adequate differential diagnosis. In our case, the study of overexpression of the MDM2 and/or CDK4 proteins allowed us to establish the definitive diagnosis.

Therapeutic interventions and results

The patient in our case underwent surgery, obtaining tumor-free margins with a favorable subsequent evolution. She currently has 18 months of disease-free survival.

Conclusion

The treatment of breast liposarcoma is mainly surgical since this sarcoma has a poor response to both chemotherapy and radiotherapy. The correct tumor resection is the most important prognostic factor for local control of the disease and long-term survival.

主要症状和/或临床表现乳腺肉瘤是一种非常罕见的肿瘤，仅占所有原发性恶性乳腺肿瘤的 1%。它的预后很差，复发风险很高。由于乳腺脂肪肉瘤的罕见性，进行充分的鉴别诊断非常重要。在我们的病例中，通过对 MDM2 和/或 CDK4 蛋白过度表达的研究，我们确定了明确的诊断。治疗干预和结果我们病例中的患者接受了手术，获得了无肿瘤边缘，随后的病情发展良好。结论乳腺脂肪肉瘤的治疗以手术为主，因为这种肉瘤对化疗和放疗的反应都很差。正确的肿瘤切除是疾病局部控制和长期生存的最重要预后因素。

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引用次数: 0

¿Es la gestación a edad materna muy avanzada éticamente aceptable? 从伦理角度讲，孕产妇晚期妊娠是否可以接受？

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Clinica e Investigacion en Ginecologia y Obstetricia

Pub Date : 2025-01-01 Epub Date: 2024-10-14 DOI: 10.1016/j.gine.2024.101003

A. Martínez-Varea

In recent years, there has been an increase in the age at which women conceive and have children, especially in developed countries.

This study aims to elucidate whether pregnancy at a very advanced maternal age is ethically acceptable or if it is better to promote pregnancy at a younger age. The specific objectives include evaluating the medical risks associated with pregnancy at a very advanced maternal age and analyzing the ethical and social implications of pregnancies at advanced maternal ages.

A systematic review was conducted using PubMed and Web of Science with the keywords pregnancy outcome, 45 years, 50 years, very advanced maternal age, menopause, ethics, bioethics. Studies published in the last 10 years in Spanish or English were included. Reviews, meta-analyses, clinical cases, letters to the editor, comments, and opinion articles were excluded.

The systematic review revealed that pregnancy at age 45 or older is associated with more adverse maternal-fetal outcomes compared to younger ages. Thus, patients of very advanced maternal age should receive appropriate prenatal counseling and close prenatal monitoring. Women of very advanced age wishing to conceive with their own oocytes should be informed about the low probabilities of success and high risk of embryonic aneuploidies. Preimplantation genetic diagnosis is recommended for women over 43 years with good ovarian reserve, and in vitro fertilization cycles should be limited to three for patients aged 44-45 years. Patients aged 45-46 years should be informed about the minimal probability of success with autologous oocytes.

As a conclusion, pregnancy at a very advanced maternal age is increasingly common and is considered ethically acceptable by both patients and specialists in reproductive medicine and obstetrics and gynecology.

本研究旨在阐明高龄产妇怀孕在伦理上是否可以接受，还是提倡在更年轻的年龄怀孕更好。具体目标包括评估与高龄产妇怀孕相关的医疗风险，并分析高龄产妇怀孕的伦理和社会影响。我们使用 PubMed 和 Web of Science 进行了系统性综述，关键词为妊娠结果、45 岁、50 岁、高龄产妇、绝经、伦理、生物伦理学。纳入了过去 10 年中以西班牙语或英语发表的研究。系统综述显示，45 岁或以上妊娠与年轻妊娠相比，会导致更多不良的母胎结局。因此，高龄产妇应接受适当的产前咨询和密切的产前监护。希望用自己的卵细胞受孕的高龄产妇应了解胚胎非整倍体的低成功率和高风险。建议对 43 岁以上、卵巢储备良好的女性进行胚胎植入前遗传学诊断，44-45 岁的患者体外受精周期应限制在三个以内。总之，高龄产妇怀孕越来越常见，而且患者和生殖医学及妇产科专家都认为这在伦理上是可以接受的。

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引用次数: 0

Perinatal outcomes in pregnant women over 45 years old: Singleton or multiple pregnancy? 45 岁以上孕妇的围产期结果：单胎妊娠还是多胎妊娠？

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Clinica e Investigacion en Ginecologia y Obstetricia

Pub Date : 2025-01-01 Epub Date: 2024-09-21 DOI: 10.1016/j.gine.2024.100996

S. Ruiz-Martínez , C. Sánchez Cabezas , N. Mateos Canals , N. Martínez-Sánchez , M. Muner , E. Martin-Boado , M. Calvo , J.L. Bartha , M. De la Calle

Introduction

Advanced maternal age is associated with a greater number of obstetric complications and adverse perinatal outcomes. It is increasingly common to find pregnant women over 45 years of age and even over 50. There are few studies that evaluate perinatal outcomes at extreme ages, over 45 years of age. Therefore, the objective of this study is to explore perinatal outcomes in the pregnancies of women over 45, as well as to compare twin and singleton pregnancies in this population.

Material and methods

An observational retrospective case–control study was carried in the Obstetrics and Gynecology Department of University Hospital La Paz (Madrid, Spain) between January 2017 and June 2023. All twin pregnancies of mother over 45 at the time of delivery as cases (n = 22) and 3 controls for each case (n = 65) were included. Perinatal outcomes were assessed and compared between singleton pregnancies and twins.

Results

The frequency of preeclampsia was statistically higher in the twin group (27.3% vs 7.7%; p = 0.017) (OR 4.5 (1.21–16.65)). Cesarean section was significant more frequent in the twin group (90.9% vs 49.2%; p = 0.001) (OR 10.31 (2.23–47.75)). In twins, prematurity rate (68.2% vs 17.2%; p < 0.001) and admission to neonatal ICU (63.6% vs 14.5%; p < 0.001) were increased. No differences were found in gestational diabetes, pregnancy-induced hypertension, small for gestational age, Apgar test < 7 at 5 min or in the pH < 7.10 in cord blood at birth.

Conclusions

Advanced maternal age is an independent risk factor for adverse perinatal outcomes and obstetric complications, independently of the number of fetuses, especially at extreme fertile ages above 45 years. In the case of twin gestations, risks inherent to twins also increase, such as prematurity, admission to the NICU and CS.

导言：高龄产妇与更多的产科并发症和不良围产期结果有关。45 岁以上甚至 50 岁以上的孕妇越来越常见。很少有研究对 45 岁以上的高龄孕妇的围产期结果进行评估。因此，本研究的目的是探讨 45 岁以上孕妇的围产期结局，并对这一人群中的双胎妊娠和单胎妊娠进行比较。材料和方法2017 年 1 月至 2023 年 6 月期间，拉巴斯大学医院（西班牙马德里）妇产科开展了一项观察性回顾病例对照研究。研究纳入了所有分娩时母亲年龄超过 45 岁的双胎妊娠病例（22 例），以及每个病例的 3 个对照组（65 例）。对围产期结果进行了评估，并对单胎妊娠和双胎妊娠进行了比较。结果从统计学角度看，双胎组先兆子痫的发生率更高（27.3% vs 7.7%; p = 0.017）（OR 4.5 (1.21-16.65)）。双胞胎组的剖宫产率明显更高（90.9% vs 49.2%；p = 0.001）（OR 10.31 (2.23-47.75)）。双胞胎的早产率（68.2% vs 17.2%；p <；0.001）和入住新生儿重症监护室的比例（63.6% vs 14.5%；p <；0.001）均有所增加。在妊娠糖尿病、妊娠高血压、胎龄小、5 分钟阿普加（Apgar）测试 7 分或出生时脐带血 pH 值 7.10 等方面没有发现差异。在双胎妊娠的情况下，双胞胎的固有风险也会增加，如早产、进入新生儿重症监护室和分娩。

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引用次数: 0

Update on second trimester ultrasound scanning in pregnancy 孕期超声波扫描的最新进展

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Clinica e Investigacion en Ginecologia y Obstetricia

Pub Date : 2025-01-01 Epub Date: 2024-09-25 DOI: 10.1016/j.gine.2024.100997

I. Pelayo-Delgado , E. Gómez-Montes , M. Álvaro-Navidad

Second trimester ultrasound is a standardised examination in pregnancy that should be routinely offered to all pregnant women, both for monitoring foetal growth and for screening for malformations. It should be performed between 18 and 24 weeks (in Spain from 18 + 0 to 22 + 0 weeks of gestation), by trained personnel and with appropriate equipment. The report should reflect foetal position and movements, biometry, amount of amniotic fluid, placental location and appearance, and foetal morphology. The foetal anatomy should include the study of the head (ossification and neurosonography), neck (discarding masses), thoracic cavity and its contents, abdomen and pelvis (studying stomach, umbilical vein, entrance of umbilical cord, kidneys, bladder), spine (in sagittal, coronal and axial planes), extremities (three segments, movement), and genitalia. Special attention should be paid to foetal heart examination (situs, four chamber view, left ventricular and right ventricular outflow-tracts, three-vessel and three-vessel-and trachea views). Neurosonography is also important with the transventricular, transcerebellar and transthalamic plane.

第二孕期超声波检查是一项标准化的孕期检查，应常规提供给所有孕妇，用于监测胎儿生长和筛查畸形。超声波检查应在妊娠 18-24 周之间进行（西班牙为妊娠 18+0-22+0 周），由经过培训的人员使用适当的设备进行。报告应反映胎位和胎动、生物测量、羊水量、胎盘位置和外观以及胎儿形态。胎儿解剖应包括头部（骨化和神经电图）、颈部（剔除肿块）、胸腔及其内容物、腹部和骨盆（研究胃、脐静脉、脐带入口、肾脏、膀胱）、脊柱（矢状面、冠状面和轴状面）、四肢（三节、运动）和生殖器。应特别注意胎儿心脏检查（坐位、四腔切面、左心室和右心室流出道切面、三血管切面、三血管和气管切面）。经脑室、经小脑和经头颅平面的神经超声检查也很重要。

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引用次数: 0

Obstetric anal sphincter injuries (OASIS) incidence. Twenty-five years’ evolution 产科肛门括约肌损伤 (OASIS) 发生率。二十五年的演变

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Clinica e Investigacion en Ginecologia y Obstetricia

Pub Date : 2025-01-01 Epub Date: 2024-09-17 DOI: 10.1016/j.gine.2024.100990

E. Alberch Camprubí , M. Mestre Costa , J. Costa Pueyo , J. Pubill Soler

Introduction

Pelvic floor disorder is an issue that affects quality of life. Obstetric anal sphincter injuries (OASIS) are related to vaginal parity and can lead to anal incontinence in 60% of women in the long term. Its identification is crucial to perform optimal surgical repair. The aim of the study was to describe obstetric trauma in our population and evolution in a 25-year period.

Material and methods

Observational retrospective study of woman who delivered in Hospital Parc Taulí between 1998 and 2021. Patients without vaginal delivery or delivery before 22nd gestational week were excluded. Data processing and analysis were performed using Excel.2016 and IBM SPSS Statistics 17.0.

Results

Sixty thousand one hundred forty-five women who delivered in our hospital over the study period were included. Fifty thousand twenty-two (83.17%) had a vaginal delivery: 82.12% were eutocic and 17.22% operative assisted. Loco regional anaesthesia was performed in 81% and the overall episiotomy rate was 59.7%. OASIS were reported in 369 women, constituting 0.74% of all vaginal deliveries, the major part detected in Kjelland forceps deliveries (representing 46.8% of OASIS) and eutocic deliveries (41.5%). Analysing the evolution of OASIS, an important reduction from 2018 to 2021 was noticeable (1.1 vs. 0.6%) and also a statistically significant difference in OASIS rate between operative and eutocic deliveries (p < 0.05).

Conclusions

The study agrees with the literature on the predominance of OASIS in forceps deliveries. It evidences a decrease in operative vaginal deliveries parallel to a significant decline of OASIS since 2018, when vacuum deliveries increased in detriment of forceps. Establishment of regular training programs appear to increase OASIS detection.

引言盆底功能障碍是一个影响生活质量的问题。产科肛门括约肌损伤（OASIS）与阴道奇偶性有关，长期可导致 60% 的妇女肛门失禁。要进行最佳的手术修复，识别肛门括约肌损伤至关重要。这项研究的目的是描述我国人口中的产科创伤情况以及 25 年间的演变过程。未经阴道分娩或在妊娠22周前分娩的患者不包括在内。数据处理和分析使用 Excel.2016 和 IBM SPSS Statistics 17.0。5.02万名（83.17%）产妇经阴道分娩：82.12%为顺产，17.22%为手术助产。81%的产妇进行了局部区域麻醉，外阴切开术的总比例为59.7%。据报告，369 名产妇发生了 OASIS，占所有阴道分娩的 0.74%，主要发生在 Kjelland 产钳助产（占 OASIS 的 46.8%）和顺产（41.5%）中。分析 OASIS 的变化，可以发现从 2018 年到 2021 年，OASIS 明显减少（1.1% 对 0.6%），而且手术分娩和顺产的 OASIS 率也有显著的统计学差异（p < 0.05）。它证明了自2018年以来，阴道手术分娩减少，同时OASIS显著下降，真空分娩增加，不利于产钳分娩。制定定期培训计划似乎能提高 OASIS 的检测率。

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引用次数: 0

Diagnostic rentability of IOTA models for differentiating between benign and malignant complex adnexal masses 用于区分良性和恶性复杂附件肿块的 IOTA 模型的诊断可租性

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Clinica e Investigacion en Ginecologia y Obstetricia

Pub Date : 2025-01-01 Epub Date: 2024-10-19 DOI: 10.1016/j.gine.2024.101000

A. Rodríguez Pérez , A. Caruso , M. Pantoja Garrido , I. Rodríguez Jiménez , A. Polo Velasco , J.J. Fernández Alba

Purpose

To evaluate the diagnostic accuracy of the International Ovarian Tumor Analysis (IOTA) Logistic Regression Model 1, 2 (LR1, LR2) ADNEX model and IOTA Simple Rules, in the pre-surgical evaluation of ovarian tumors classified as complex adnexal masses.

Methods

This is a cross-sectional observational study of diagnostic accuracy. We will select patients, who undergo surgical intervention due to adnexal mass with indeterminate, intermediate or high suspicion of malignancy (GI-RADS 4–5), as assessed by an expert ultrasound operator. We analyzed and compared the diagnostic performance and predictive capacity of the different models in the studied population, and also we analyzed each model by creating subgroups based on menopausal status.

Results

One hundred thirty five malignant masses (45%), one hundred forty benign (46.7%) and twenty five border line (8.3%) were included.

LR1 and LR2 models, and ADNEX were applicable to all lesions; however, in 72 lesions (24%), the simple rules were inconclusive.

We observed better performance for LR1 and simple rules, based on the following results: Sensitivity: LR1 91%. Specificity: simple rules 86%. PPV: simple rules 79%. NPV: LR1 88%.

Conclusions

Our study suggests that the subgroup of patients with complex adnexal masses, the IOTA risk stratification through LR1 shows higher sensitivity for risk stratification of malignancy, while simple rules has the highest specificity and diagnostic accuracy. However, it is inconclusive in one out of every four adnexal masses. Additionally, LR1–LR2 and ADNEX do not show significant differences in diagnostic accuracy.

目的评价国际卵巢肿瘤分析（IOTA）逻辑回归模型 1、2（LR1、LR2）ADNEX 模型和 IOTA 简单规则在手术前评估归类为复杂附件肿块的卵巢肿瘤时的诊断准确性。我们将选择因附件肿块而接受手术治疗的患者，由超声波操作专家评估其恶性程度为不确定、中度或高度怀疑（GI-RADS 4-5）。我们分析并比较了不同模型在研究人群中的诊断性能和预测能力，还根据绝经状态创建了亚组，对每个模型进行了分析。LR1和LR2模型以及ADNEX适用于所有病变；然而，在72个病变（24%）中，简单规则无法得出结论：灵敏度灵敏度：LR1 91%。特异性：简单规则为 86%。PPV：简单规则 79%。结论我们的研究表明，在复杂附件肿块患者亚组中，通过 LR1 进行 IOTA 风险分层对恶性肿瘤风险分层的敏感性更高，而简单规则的特异性和诊断准确性最高。然而，每四个附件肿块中就有一个是不确定的。此外，LR1-LR2 和 ADNEX 在诊断准确性上也没有明显差异。

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引用次数: 0

Fisioterapia en el dolor tras cesárea 剖腹产后疼痛的物理治疗

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Clinica e Investigacion en Ginecologia y Obstetricia

Pub Date : 2025-01-01 Epub Date: 2024-10-16 DOI: 10.1016/j.gine.2024.101002

L. Monroy Martínez , I. Da Cuña Carrera , A. Alonso Calvete , L. Núñez Remiseiro , M. Fernández Paz

Cesarean section is one of the most commonly performed surgeries in obstetrics and involves the removal of a neonate through an abdominal and uterine incision. This intervention can cause different consequences, such as pain, which can be treated using physiotherapy techniques. The objective of this work is to analyze the existing literature to know what the effects of physiotherapy are on pain after cesarean section. A bibliographic search was carried out in the databases PudMed, Cinahl, Medline, PEDro, Scopus, Web of Science and ENFISPO. The search terms «Pain», «Cesarean Section», «Physiotherapy», «Physical Therapy» and «Physical Therapy Modalities» were used. Studies were limited to randomized clinical trials published in English or Spanish. Of the 220 initial results, 12 articles were chosen for analysis. The therapies carried out were varied, including electrotherapy, massage therapy and cryotherapy to analyze different variables. Physiotherapy is beneficial in controlling pain in patients after a cesarean section through techniques such as TENS. Other therapies such as massage therapy and cryotherapy seem to obtain some improvements, but it cannot be concluded that they have significant benefits.

剖腹产是产科中最常见的手术之一，需要通过腹部和子宫切口将新生儿取出。这种干预可能会导致不同的后果，例如疼痛，而疼痛可以通过物理治疗技术进行治疗。本研究旨在分析现有文献，了解物理治疗对剖宫产术后疼痛的影响。我们在 PudMed、Cinahl、Medline、PEDro、Scopus、Web of Science 和 ENFISPO 等数据库中进行了文献检索。搜索关键词为 "疼痛"、"剖腹产"、"物理疗法"、"物理疗法 "和 "物理疗法模式"。研究仅限于以英语或西班牙语发表的随机临床试验。在 220 项初步结果中，有 12 篇文章被选中进行分析。所采用的疗法多种多样，包括电疗、按摩疗法和冷冻疗法，以分析不同的变量。物理疗法有助于通过 TENS 等技术控制剖腹产后患者的疼痛。其他疗法，如按摩疗法和冷冻疗法，似乎也有一定的改善作用，但不能断定它们有明显的益处。

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引用次数: 0

Bases fisiológicas, técnicas y principales indicaciones de preservación de la fertilidad en la paciente oncológica 肿瘤患者保留生育能力的生理基础、技术和主要适应症。

IF 0.1 Q4 OBSTETRICS & GYNECOLOGY

Clinica e Investigacion en Ginecologia y Obstetricia

Pub Date : 2025-01-01 Epub Date: 2024-10-28 DOI: 10.1016/j.gine.2024.101005

Y. Barral , M. Vidal , S. Peralta , L. Magnano

In recent decades, the use of fertility preservation techniques in women with oncologic pathology has increased, aiming to improve their future reproductive prognosis. This trend is attributed to the increasing incidence of neoplasms in women of reproductive age, improved survival rates, and the progressive delay of motherhood. The gonadotoxicity of chemotherapy is influenced by factors like the patient's age, baseline ovarian reserve, and the type and cumulative dose of chemotherapy. Therefore, it is crucial to provide appropriate reproductive counseling and refer patients to specialized fertility preservation programs, where comprehensive assessment of gonadotoxic risk and individual patient risk are performed. Oocyte cryopreservation is the main technique for fertility preservation, non-experimental since 2013. Controlled ovarian stimulation starts at any phase of the menstrual cycle (random start), avoiding the delay in starting chemotherapy. In addition, the treatment with letrozole is recommended to breast cancer patients performing ovarian stimulation to prevent excessive increases in serum estrogen levels. The ovarian cortex cryopreservation is still considered experimental in many countries. However, it is performed in some cases, for example, when chemotherapy cannot be delayed for 2 weeks or in prepubertal patients. At the present time, gonadotropin-releasing hormone (GnRH) treatment is not regarded as a fertility preservation technique. However, it can be employed in certain clinical contexts.

近几十年来，对患有肿瘤病变的妇女使用生育力保存技术的情况越来越多，目的是改善她们未来的生殖预后。这一趋势归因于育龄妇女肿瘤发病率的增加、生存率的提高以及生育年龄的逐渐推迟。化疗的性腺毒性受患者年龄、卵巢基线储备、化疗类型和累积剂量等因素的影响。因此，为患者提供适当的生殖咨询并将其转诊至专门的生育力保存项目至关重要，在这些项目中，将对性腺毒性风险和患者的个体风险进行全面评估。卵母细胞冷冻保存是保存生育能力的主要技术，自2013年以来一直是非实验性的。受控卵巢刺激可在月经周期的任何阶段开始（随机开始），避免了开始化疗的延迟。此外，建议乳腺癌患者接受来曲唑治疗，以防止血清雌激素水平过度升高。在许多国家，卵巢皮质冷冻保存仍被认为是实验性的。不过，在某些情况下，如化疗不能推迟两周或青春期前的患者，也会进行卵巢皮质冷冻保存。目前，促性腺激素释放激素（GnRH）治疗不被视为生育力保存技术。不过，在某些临床情况下可以使用。

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引用次数: 0