Center for Reproductive Health After Disease

描述(申请人提供)：癌症现在是一种疾病，有许多高效的治疗选择，导致更多的癌症幸存者长寿和多产。在全球范围内，有1000万人被诊断患有癌症，新诊断的男女中有10%的人年龄在40岁以下。虽然积极的放射和化疗能够挽救和延长他们的生命，但生殖功能--包括生育和内分泌功能--的中断可能是一种意想不到的后果，对这些年轻的癌症患者来说尤其相关。我们还认识到，许多年轻妇女患有非恶性疾病，或必须接受可能损害其生殖功能的药物或程序治疗。因此，拟议的西北大学疾病后生殖健康中心将扩大总体工作范围，以确保向这些妇女提供保护其生殖健康的选择，并确保提供者意识到特定疾病和治疗对生殖功能构成的威胁。此外，我们的中心将不仅限于保留生育能力，还将解决丧失性腺功能的女性的长期内分泌健康问题。每年有20,000名年龄在41岁到51岁之间的女性被诊断出患有癌症，虽然这些女性超出了实验性生育干预的年龄限制，但她们需要 替代方案，将保留各种组织的卵巢内分泌支持，如骨骼。该中心的总体假设是，可以为患有恶性或非恶性疾病的年轻女性提供有效的选择，这些女性必须接受保命的癌症治疗和其他影响其生殖健康的医疗干预。通过组建一支多样化、跨学科的调查团队，该中心将从事基础科学研究和 临床研究目标，以及创建和实施教育和社区推广倡议，以与提供者、患者、他们的家人和公众分享中心的研究结果 中心研究人员将研究从年轻癌症患者储存的卵巢组织中的未成熟卵母细胞池中生产健康、成熟卵母细胞的新技术。另一个项目将研究可能有针对性的细胞机制，以保护卵子免受辐射和化疗的破坏性影响；这项工作对保护老年妇女的内分泌健康尤为重要。将进行临床研究，以确定对生育问题的担忧在多大程度上影响患者的医疗决策过程。随着范围的扩大，以团队为基础的解决问题的方法，以及不仅要保护生育力，而且要保护生殖健康的所有方面的目标，我们的中心有可能影响许多面临疾病相关或医源性不孕和内分泌功能障碍风险的年轻女性的生活。

DESCRIPTION (provided by applicant): Cancer is now a disease with a number of highly effective treatment options that are leading to a greater number of cancer survivors who are living long and productive lives. Globally, there are 10 million people diagnosed with cancer, and 10% of newly diagnosed men and women are under the age of 40 years. While aggressive radiation and chemotherapies are able to save and prolong their lives, disruption of reproductive function-including fertility and endocrine function-can be an unintended consequence that is particularly relevant for these young cancer patients. We have also come to recognize that many young women have non-malignant conditions or must undergo treatment with drugs or procedures that can damage their reproductive function. The proposed Northwestern University Center for Reproductive Health After Disease will therefore extend the overall scope of work to ensure that these women are provided options for protecting their reproductive health and that providers are aware of the threat posed by specific diseases and treatments on reproductive function. Moreover, our Center will not be limited to the preservation of fertility but will also address the long-term endocrine health of women who lose gonadal function. There are 20,000 women between the ages of 41 and 51 who are diagnosed with cancer each year, and while these women lie outside the age limit for experimental fertility interventions, they are in need of alternatives that will preserve ovarian endocrine support of various tissues, such as bone. The overall hypothesis of the Center is that effective options can be provided to young women with malignant or non-malignant disease who must undergo life-preserving cancer treatments and other medical interventions that will affect their reproductive health. By assembling a diverse, cross-disciplinary team of investigators, the Center will pursue both basic scientific research and clinical research goals, as well as create and implement educational and community outreach initiatives to share the Center's findings with providers, patients, their families, and the public Center researchers will investigate new techniques for producing healthy, mature oocytes from the pool of immature oocytes in ovarian tissue banked by young cancer patients. Another project will examine the cellular mechanisms that might be targeted to protect eggs from the damaging effects of radiation and chemotherapy; this work will be particularly important for preserving endocrine health in older women. Clinical research will be conducted to determine to what extent fertility concerns affect the medical decision making process of patients. With an expanded scope, a team-based approach to problem solving, and the goal of preserving not only fertility, but all aspects of reproductive health, our Center has the potential to impact the lives of many young women who are at risk of disease-related or iatrogenic infertility and endocrine dysfunction.