女性生育力保护的现状与进展

doi:10.6040/j.issn.1671-7554.0.2022.0916

摘要/Abstract

摘要： 生育力保护是一个新兴的、快速发展的跨学科领域。近年该领域研究取得了巨大进展,生育力保护新技术得到了广泛应用。实施生育力保护是保留生育能力和解决不孕问题的重要环节,首先,能保护患者的生育能力免受疾病或环境因素损伤,如年轻肿瘤患者卵子或卵巢组织的体外冷冻保存;其次,以生育为主要目的的手术,解决部分不孕患者的病因,修复或重建生殖器官的结构与功能;最后,作为辅助生殖措施的补充治疗,可以提高辅助生殖的成功率。本文着重强调生育力保护方面的主要发展,指出这一新的研究领域仍然面临的挑战,并就中国生育力保护的发展提出建议。

关键词: 肿瘤生育学, 癌症治疗, 生育力保护, 生存质量, 健康管理

Abstract: Fertility protection, as a new and rapidly developing interdisciplinary field in recent years, has made great progress and applied fertility preservative technology(FPT)which plays important roles in preserving fertility and solving infertility problems. FPT such as in vitro cryopreservation of the eggs or ovarian tissues from young tumor patients can protect patients' fertility from disease-related damages or environmental-impacted infertility. Surgical measures with primary purpose to keep fertility can solve problems resulting in infertility and repair or reconstruct the structure and function of the reproductive organs. Assisted reproductive treatment as a complement measure can rate up the success of assisted reproduction. In this article, we will highlight the significant developments of fertility preservation, identify the challenges to be faced and put forward recommendations for the development of fertility preservative technology in China.

Key words: Oncofertility, Cancer therapies, Fertility preservation, Quality of life, Healthcare management

中图分类号:

R711.6

吴瑞芳,李长忠. 女性生育力保护的现状与进展[J]. 山东大学学报 (医学版), 2022, 60(9): 1-7.

WU Ruifang, LI Changzhong. Status and progress of female fertility protection[J]. Journal of Shandong University (Health Sciences), 2022, 60(9): 1-7.

参考文献

[1] Tamrakar SR, Bastakoti R. Determinants of infertility in couples[J]. J Nepal Health Research Council, 2019, 17(1): 85-89.
[2] Zhang P. What can be learned from the Chinese experience in response to infertility[J]. Eur J Contracept Reprod Health Care, 2020, 25(4): 311-313.
[3] Melan K, Amant F, Veronique-Baudin J, et al. Fertility preservation healthcare circuit and networks in cancer patients worldwide: what are the issues?[J]. BMC Cancer, 2018, 18(1): 192. doi: 10.1186/s12885-018-4046-x.
[4] Anazodo A, Laws P, Logan S, et al. How can we improve oncofertility care for patients? a systematic scoping review of current international practice and models of care[J]. Hum Reprod Update, 2019, 25(2): 159-179.
[5] Brungardta JG, Burnsb KC, Dasgupt R. Fertility preservation in children and young adults with cancer[J]. Curr Opin Pediatr, 2022, 34(1): 48-52.
[6] Gargus E, Deans R, Anazodo A, et al. Management of primary ovarian insufficiency symptoms in survivors of childhood and adolescent cancer[J]. J Natl Compr Canc Netw, 2018, 16(9): 1137-1149.
[7] Dolmans MM, von Wolff M, Poirot C, et al. Transplantation of cryopreserved ovarian tissue in a series of 285 women: a review of five leading European centers[J]. Fertil Steril, 2021, 115(5): 1102-1114.
[8] Moravek MB, Appiah LC, Anazodo A, et al. Development of a pediatric fertility preservation program: a report from the pediatric initiative network of the oncofertility consortium[J]. J Adolesc health, 2019, 64(5): 563-573.
[9] Mitchell RT, Williams SA. A fertile future: fertility preservation special series[J]. Reprod Fertil, 2022, 3(1): C1-C3.
[10] Rodriguez-Wallberg KA, Xia Hao, Marklund A, et al. Hot topics on fertility preservation for women and girls-current research, knowledge gaps, and future possibilities[J]. J Clin Med, 2021, 10(8): 1650. doi:10.3390/jcm10081650.
[11] Edimiris P, Krüssel JS. Fertility-preserving options before gonadotoxic antirheumatic therapy[J]. J Rheumatol,2021, 80: 726-732. doi.org/10.1007/s00393-021-01075-3.
[12] Dolmans MM, Donnez J. Fertility preservation in women for medical and social reasons: Oocytes vs ovarian tissue[J]. Best Pract Res Clin Obstet Gynaecol, 2021, 70: 63-80. doi: 10.1016/j.bpobgyn.2020.06.011.
[13] Arecco L, Ruelle T, Martelli V, et al. How to protect ovarian function before and during chemotherapy?[J]. J Clin Med, 2021, 10(18): 4192. doi: 10.3390/jcm10184192.
[14] Valsamakis G, Valtetsiotis K, Charmandari E, et al. GnRH analogues as a co-treatment to therapy in women of reproductive age with cancer and fertility preservation[J]. Int J Mol Sci, 2022, 23(4): 2287. doi:10.3390/ijms23042287.
[15] Kado R, McCune WJ. Ovarian protection with gonadotropin-releasing hormone agonists during cyclophosphamide therapy in systemic lupus erythematosus[J]. Best Pract Res Clin Obstet Gynaecol, 2020, 64: 97-106. doi: 10.1016/j.bpobgyn.2019.10.008.
[16] Taylan E, Oktay K. Fertility preservation in gynecologic cancers[J]. Gynecol Oncol, 2019, 155(3): 522-529.
[17] Dietrich JE, Millar DM, Quint EH.Obstructive reproductive tract anomalies[J]. J Pediatr Adolesc Gynecol, 2014, 27(6): 396-402.
[18] Tielli A, Scala A, Alison M, et al. Ovarian torsion: diagnosis, surgery, and fertility preservation in the pediatric population[J]. Eur J Pediatr, 2022, 181(4): 1405-1411.
[19] Zhong SL, Zeng LP, Li H, et al. Development and evaluation of an improved laparoscopic myomectomy adopting intracapsular rotary-cut procedures[J]. Eur J Obstet Gynecol Reprod Bio, 2018, 221: 5-11. doi: 10.1016/j.ejogrb.2017.11.021.
[20] Zeng LP, Wei WX, Tang HR, et al. Introduction of intracapsular rotary-cut procedures(IRCP): a modified hysteromyomectomy procedures facilitating fertility preservation[J]. J Vis Exp, 2019, 143: doi: 10.3791/58410.
[21] Osada H, Silber S, Kakinuma T, et al. Surgical procedure to conserve the uterus for future pregnancy in patients suffering from massive adenomyosis[J]. Reprod Biomed Online, 2011, 22(1): 94-99.
[22] Wu RF, Zeng LP, Hu QC, et al. Clinical efficacy and safety of fertility-preservative PUSH surgery for diffuse adenomyosis: evidence from a 11-year prospective investigation[J]. Preprints with Lancet, 2021. doi: 10.2139/ssrn.3916093.
[23] 子宫腺肌症伴不孕症诊疗中国专家共识编写组. 子宫腺肌病伴不孕症诊疗中国专家共识[J]. 中华生殖与避孕杂志, 2021, 41(4): 287-295.
[24] Zhang Y, Zhou XM, Zhu Y, et al. Current mechanisms of primordial follicle activation and new strategies for fertility preservation[J]. Mol Hum Rwprod, 2021, 27(2): gaab005. doi: 10.1093/molehr/gaab005.
[25] Zhang W, Nie RT, Cai YH, et al. Progress in germline stem cell transplantation in mammals and the potential usage[J]. Reprod Biol Endocrinol, 2022, 20(1): 59. doi: 10.1186/s12958-022-00930-5.
[26] Kim JM, Kim S, SH Lee. Role of Stem Cells in the Ovarian Tissue Cryopreservation and Transplantation for Fertility Preservation[J]. Int J Mol Sci, 2021, 22(22): 12482. doi: 10.3390/ ijms222212482.
[27] Silvestris E, Palma GD, Canosa S, et al. Human ovarian cortex biobanking: a fascinating resource for fertility preservation in cancer[J]. Int J Mol Sci, 2020, 21(9): 3245. doi: 10.3390/ijms21093245.
[28] Yasmin E, Mitchell R, Lane S. Preservation of fertility in teenagers and young adults treated for haematological malignancies[J]. Lancet Haematol, 2021, 8(2): e149-e160.
[29] Strowitzki T, Bruckner T, Roesner S. Maternal and neonatal outcome and childrens development after medically assisted reproduction with in-vitro matured oocytes—a systematic review and meta-analysis[J]. Hum Reprod update, 2021, 27(3): 460-473.
[30] Dolmans MM, Amorim CA. Construction and use of artificial ovaries[J]. Reproduction, 2019, 158(5): F15-F25.
[31] Salama M, Woodruff TK. From bench to bedside: current developments and future possibilities of artificial human ovary to restore fertility[J]. Acta Obstet Gynecol Scand, 2019, 98(5): 659-664.
[32] Xiong JQ, Xue LR, Li Y, et al. Therapy of Endocrine Disease: novel protection and treatment strategies for chemotherapy-associated ovarian damage[J]. Eur J Endocrinol, 2021, 184(5): R177-R192.

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