Reproductive function in teenage and young adult cancer patients in the UK

对于面临新癌症诊断的年轻人来说，可能的生育能力丧失是最重要的担忧之一。然而，我们在准确预测谁需要保持生育能力方面仍然存在很大差距。近年来，随着卵子和精子储存的改善，以及卵巢和睾丸组织冷冻的可能性也增加了，“保持生育能力”领域得到了发展，但这些治疗方法往往很复杂，可能会推迟癌症治疗的开始，可能需要外科手术，特别是对年轻患者，而且并不是所有的患者都需要或可以接受手术。有关成功率的数据也很有限。这些因素都极大地影响了为临床医生提供适当的护理和转诊以及为患者做出决策的挑战。癌症的治疗方法正在改变和改进，我们对新的治疗方法或决定个体对生育能力丧失的易感性的因素知之甚少。在这项研究中，我们将测量当前和新的癌症治疗方法对面临新癌症诊断的青少年和青年(TYA)男性和女性生殖功能的影响，这些男性和女性是从英国各地的TYA癌症中心招募的。我们将包括所有癌症类型，使我们能够收集关于不太常见的以及更常见的疾病及其治疗的信息。为了跟上癌症治疗的发展，我们将通过这项研究收集关于新的和新兴的治疗方法的信息，尽可能提供最新的分析。我们将收集临床信息(包括接受治疗的细节)和血液样本，以测量反映卵巢和睾丸功能的激素。重要的是，我们将在治疗开始前、治疗结束后和之后每隔一段时间开始收集这些样本。这将使我们能够确定哪些治疗对男性和女性的生殖功能有影响，哪些因素在治疗开始前是重要的，从而确定这一点。从长远来看(取决于正在进行的资助)，我们将把这项研究中收集的信息与正在进行的NHS记录联系起来，看看它与关键的生育事件-怀孕和当父亲，以及女性到(可能提前)更年期的时间-之间的关系。

The possible loss of fertility is one of the most important concerns of young people facing a new cancer diagnosis. However there remain big gaps in our ability to predict accurately who needs to preserve their fertility. While the field of 'fertility preservation' has developed over recent years, with improvements in egg and sperm storage and freezing of ovarian and testicular tissue now also possible, these treatments are often complex, may delay the start of cancer treatment, may need surgical procedures especially for younger patients, and not all patients either need or can have them. Data on success rates are also limited. These factors all greatly impact on the challenges of providing appropriate care and referral for clinicians, and decision making for patients. Cancer treatments are changing and improving, and we know very little about new treatments or factors that determine individual's susceptibility to loss of fertility. In this study we will measure the effects of current and new cancer treatments on the reproductive function of teenage and young adult (TYA) males and females who are facing a new cancer diagnosis, recruited from TYA cancer centres across the UK. We will include all cancer types, allowing us to gather information on the less common as well as more common conditions and their treatments. To keep up with developments in cancer treatment, through this study we will collect information on new and emerging treatments, giving the most up to date analysis possible. We will collect clinical information (including details of treatment received), and blood samples to measure hormones that reflect the function of the ovaries and testes. Importantly, we will start collecting these samples before treatment starts, then after the end of treatment and at intervals thereafter. This will allow us to determine which treatments do and do not affect reproductive function in both males and females and what factors are important before treatment starts, in determining this. Over the longer term (subject to ongoing funding) we will link the information gathered in this study to ongoing NHS records to see how it relates to key fertility events-pregnancy and paternity, and in females, time to (potentially early) menopause.