伊朗癌症妇女的生育力保留及其结果:纵向队列研究

B. Hossein Rashidi, Marjan Ghaemi, Ensieh Shahrokh Tehrani, Marzieh Mohebbi, Marzieh Savari
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摘要

10.30699/jogcr.8.5.446 背景与目的:癌症女性患者在接受治疗干预前保留生育能力非常重要。本研究旨在评估一家辅助生育中心从 2013 年至 2020 年 8 年来在女性癌症幸存者生育力保存及其结果方面的经验。材料与方法:参与者为经批准确诊为癌症的育龄女性,她们被转诊为生育力保存患者。在经过专家团队的适当咨询后,根据患者的病情和生存预期,最终决定采用何种生育力保存方法。主要目的是收集这些妇女的生育力、临床和生存结果的数据,并将怀孕率作为次要目标,在不同癌症类型之间进行比较。研究结果共招募了 337 名参与者,平均(±SD)年龄为 30.7±6.6 岁。妇科癌症占所有病例的 166 例(49.3%),其次分别是乳腺癌(107 例(31.8%))和其他癌症(64 例(19.0%))。其中,144 例(42.7%)进入了促排卵周期,其他病例没有继续治疗的主要原因是缺乏正确的信息和转诊过晚,以及无法推迟治疗。比较三组(妇科癌症、乳腺癌和其他癌症),发现妇科癌症幸存者的怀孕率较高,但无统计学差异。在乳腺癌幸存者中,取卵和生育的机会并不比其他癌症低。结论许多患者甚至他们的治疗师都不熟悉保留生育能力的方法,当他们考虑保留生育能力时,黄金时间往往已经过去。因此,与幸存者进行良好的咨询和患者教育可能是导致癌症患者及时转诊以保留生育能力的最重要问题。
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Preserving Fertility and Its Outcomes in Iranian Women with Cancer: A Longitudinal Cohort Study
10.30699/jogcr.8.5.446 Background & Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the 8 years’ experience of an onco-fertility center from 2013 to 2020 on fertility preservation and its outcomes in female cancer survivors. Materials & Methods: Participants were females with an approved cancer diagnosis of reproductive ages that were referred for fertility preservation. After proper counseling by an expert team, the final decision on the fertility preservation method was made based on the patient's condition and survival expectation. The primary goal was to collect data about the fertility, clinical and survival outcomes of these women and pregnancy rate as a secondary objective that were compared between cancer types. Results: Totally 337 participants were recruited with a mean±SD age of 30.7±6.6 years. Gynecological cancers accounted for 166 (49.3%) of all cases followed by breast (107 (31.8%)) and other cancers (64 (19.0%)) respectively. Of those, 144 (42.7%) cases entered into the ovulation induction cycle and the others did not continue due to lack of correct information and late referral, and inability to postpone treatment as the major reasons. Comparing between 3 groups (gynecological, breast and other cancers), a higher rate of pregnancy otherwise not statistically different was detected in gynecological cancer survivors. In the breast cancer survivors, the chance of oocyte retrieval and fertility was not lower than in other cancers. Conclusion: Many patients and even their therapists are unfamiliar with the methods of fertility preservation, and when they consider it, the golden time is usually passed. Therefore, having a good consultation with the survivors and patient education may be the most important issue that led to a timely referral for preserving fertility in cancer patients.
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