女性生育能力保存:当前和未来的策略

Nouran Sallam, R. Hemida
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摘要

近年来,各种恶性肿瘤的诊断、治疗和预后都取得了惊人的进展,这增加了对生育能力保存的要求。生育障碍被认为是成功战胜癌症的女性放射/细胞毒性治疗的并发症之一。保留生育能力的问题也涉及那些有卵巢功能衰竭风险的人,以及旨在克服与年龄有关的生育能力下降的健康个体。关于保留女性生育能力,可根据各种因素选择各种方案,包括患者的年龄、疾病类型以及治疗的类型和紧迫性。在这些选择中,胚胎/卵母细胞冷冻保存以及卵巢组织冷冻保存和自体移植分别是青春期后和青春期前患者最可靠的方式。此外,人工卵巢、卵泡和未成熟卵母细胞的分离和冷冻保存、潜在的药理学性腺保护剂和干细胞移植等新技术在未来也有应用的潜力。本文重点介绍了当前和未来的女性生育保护策略。
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Female Fertility Preservation: Current & Future Strategies
Recently, the spectacular progress in diagnosis, treatment, and prognosis of different malignancies has increased the demands on fertility preservation. Fertility impairment is considered one of the complications of radio/cytotoxic treatments in females who managed to overcome their cancer. This issue of fertility preservation also concerns those who are at risk of developing ovarian failure as well as healthy individuals who aim to overcome age-related fertility decline. Regarding female fertility preservation, there are various options that could be selected according to various factors, including the patient’s age, type of the disease, as well as type and urgency of treatment. Among these options, embryo/oocyte cryopreservation as well as ovarian tissue cryopreservation and autotransplantation are the most reliable modalities for post- and pre- pubertal patients, respectively. Moreover, novel techniques such as the artificial ovary, isolation and cryopreservation of follicles and immature oocyte, potential pharmacological gonadoprotective agents, and stem cells transplantation have the potential to be used in the future. In this article, current and future female fertility preservation strategies are highlighted .
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