冷冻保存选择以保持女性癌症患者的生育能力:从肿瘤学指南的角度来看,可用的临床实践和研究策略

L. Mirzaeian, Haniyeh Rafipour, S. Hashemi, S. Zabihzadeh, S. Amanpour
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引用次数: 4

摘要

近年来,癌症治疗的进步显著提高了癌症患者的生存率。然而,由于治疗或癌症本身对卵巢的破坏性损伤可导致育龄妇女不同程度的不孕症,严重影响她们的生活质量。本研究综述了肿瘤学指南中女性癌症患者生育能力冷冻保存的选择。低温保存方法在生殖生物学和肿瘤学领域有着悠久的历史。然而,胚胎和卵母细胞冷冻保存是临床肿瘤实践中合适的恢复策略。卵巢组织冷冻保存(OTC)是最新推荐的生育能力保存的选择,在青春期前和成年患者不能延迟他们的治疗或服用体外受精激素可能对他们的癌症有不利影响。报告显示,迄今为止,冷冻解冻卵巢组织移植已导致130多名患者活产,其中大多数是癌症患者。虽然OTC确实被普遍认为是一种研究方法,但在一些重要的指南(如ASCO 2018)中推荐使用。因此,基于许多临床证据,我们预测该临床标签将很快被移除,OTC可能被认为是临床肿瘤学实践中女性癌症患者的主要生育能力保存选择之一。
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Cryopreservation Options to Preserve Fertility in Female Cancer Patients: Available Clinical Practice and Investigational Strategies from the Oncology Guidelines Point of View
In recent years, advances in cancer treatment have improved the survival rate of cancer patients significantly. However, destructive damage to ovaries due to the therapies or cancer itself can cause different degrees of infertility in women of reproductive age that can affect their quality of life seriously. In this study, fertility cryopreservation options for female cancer patients in oncology guidelines were reviewed. Cryopreservation methods have a long history in reproductive biology and oncology. However, embryo and oocyte cryopreservation were the eligible restoration strategies in clinical oncology practice. Ovarian tissue cryopreservation (OTC) is the latest option recommended for fertility preservation in pre-pubertal and adult patients who cannot delay their treatment or in whom taking IVF hormones may have adverse effects on their cancer. Reports show that frozen-thawed ovarian tissue transplantation has led to more than 130 live births so far in patients, most of whom were cancer patients. Although OTC is indeed generally recognized as an investigational method, it is recommended in some important guidelines, such as ASCO 2018. Therefore, based on many clinical pieces of evidence , it is predicted that the investigational label will soon be removed, and OTC might be considered as one of the main fertility preservation options for female cancer patients in clinical oncology practice.
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