Medical and psychosocial aspects of fertility after cancer.
Medical and psychosocial aspects of fertility after cancer.
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DOI：
10.1097/ppo.0b013e3181976602
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发表时间：
2009-01
期刊：
影响因子：
--
通讯作者：
Allen S
中科院分区：
文献类型：
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作者：
Duffy C;Allen S
过去 25 年中，癌症生存率显着提高，总体 5 年和 10 年生存率优异。因此，大多数被诊断患有癌症的年轻女性预计可以活几十年，这使得生育等生活质量问题变得越来越重要。不孕的风险因所采用的化疗和治疗以及女性年龄而异。一般来说，年轻女性比老年女性经历永久性闭经的可能性较小，但即使是持续月经的女性，过早绝经的风险也会大大增加。对于希望保留生育能力的接受化疗的癌症患者来说，选择范围从临床成熟的技术（如胚胎冷冻保存）到更具实验性的技术（如卵巢组织冷冻保存）。怀孕似乎不会增加癌症复发的风险。关于诊断患有癌症的绝经前妇女的生育问题的讨论给提供者和患者带来了重要的挑战。然而，未能充分讨论这些选择可能会对女性的生活质量产生持久的负面影响。医生教育干预措施应寻求提高对保留生育能力的选择以及当地和国家可用资源的了解。
Survival for cancer has improved significantly in the last 25 years with excellent overall 5-year and 10-year survival rates. Hence, the majority of young women diagnosed with cancer can expect to live for decades, making quality of life issues such as fertility increasingly important. Risks of infertility vary based on the chemotherapy and treatments employed, as well as a woman’s age. In general, younger women are less likely to experience permanent amenorrhea than older women, but even women who continue to menstruate have a greatly increased risk of premature menopause. Options for cancer patients entering chemotherapy treatment who wish to preserve fertility range from clinically well-established techniques such as embryo cryopreservation to more experimental techniques such as ovarian tissue cryopreservation. Pregnancy does not appear to increase the risk of cancer recurrence. Discussion of fertility issues in premenopausal women diagnosed with cancer present important challenges to the provider and to the patient. However, failure to discuss these options adequately can have lasting negative consequences on a woman’s quality of life. Physician education interventions should seek to improve the knowledge of fertility preservations options, and of locally and nationally available resources.