国际生殖健康/计划生育 ›› 2019, Vol. 38 ›› Issue (1): 71-74.

• 综述 • 上一篇    下一篇

接受放化疗年轻女性恶性肿瘤患者的生育能力保存

王秋曼,赵烨,姚丽婷,韩骁,曹洁琼   

  1. 030001 太原,山西医科大学第一临床医学院(王秋曼,姚丽婷,韩骁,曹洁琼);山西医科大学第一医院(赵烨)
  • 收稿日期:2018-08-12 修回日期:2018-10-19 出版日期:2019-01-15 发布日期:2019-01-15
  • 通讯作者: 赵烨,E-mail:643818222@qq.com E-mail:643818222@qq.com

Fertility Preservation of Young Women Undergoing Chemoradiotherapy

WANG Qiu-man,ZHAO Ye,YAO Li-ting,HAN Xiao,CAO Jie-qiong   

  1. The First Clinical Medical College of Shanxi Medical University,Taiyuan 030001,China(WANG Qiu -man,YAO Li-ting,HAN Xiao,CAO Jie-qiong.);The First Hospital of Shanxi Medical University,Taiyuan 030001,China(ZHAO Ye)
  • Received:2018-08-12 Revised:2018-10-19 Published:2019-01-15 Online:2019-01-15
  • Contact: ZHAO Ye,E-mail:643818222@qq.com E-mail:643818222@qq.com

摘要: 放疗和化疗对恶性肿瘤的治疗至关重要,但会对年轻女性患者的生育功能造成负面影响,引起不孕。在放化疗前,可以为女性提供多种保留生育能力的选择,包括:卵巢移位、胚胎和卵母细胞冷冻保存、卵巢组织冷冻保存、药物保护性治疗等。将卵巢移位至结肠肝脾曲外侧,可以减少卵巢承受的放射量。卵母细胞和胚胎冷冻保存技术已经成熟,但也有其局限性。卵巢组织冷冻保存目前仍处于试验阶段,已有80多例成功妊娠的案例报道。在化疗期间使用促性腺激素释放激素类似物抑制卵巢功能治疗是一种有争议的保留生育能力的方法。肿瘤医生和生殖医生需要进行多学科合作,权衡保留生育能力与癌症相关的复发率和死亡率,制定个体化治疗方案。

关键词: 生育力, 生殖技术, 辅助, 抗肿瘤联合化疗方案, 放射疗法, 妇女,

Abstract: Radiotherapy and chemotherapy are essential for the treatment of malignant tumors. However, chemoradiothery will have a negative impact on the reproductive function of young women, causing infertility. Before radiotherapy and chemotherapy, many fertility-preserving options can be provided, including ovarian transposition, embryo and oocyte cryopreservation, ovarian tissue cryopreservation , and drug-protective therapy. Transposition of the ovary to the outside of the hepatic flexure or splenic flexure of the colon can reduce the amount of radiation that the ovary bears. Oocyte and embryo cryopreservation is a mature technique, with its limitations. Cryopreservation of ovarian tissue is currently at clinical trial stage, with over 80 cases' reports. Inhibition of ovarian function with gonadotropin releasing hormone analogue during chemotherapy is a controversial method of preserving fertility. Oncologists and reproductive doctors need multidisciplinary collaboration to balance the fertility and the recurrence rate and mortality associated with cancer,so as to make the individualized treatment.

Key words: Fertility, Reproductive technology, assisted, Antineoplastic combined chemotherapy protocols, Radiotherapy, Women, Carcinoma