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Chemotherapy for gynaecological malignancies and fertility preservation

World Journal of Obstetrics and Gynecology 2014年第2期3卷 54-60页

作者： Joseph J Sacco joanne cliff John A Green Department of Medical Oncology Clatterbridge Cancer Centre Bebington Wirral CH63 4JY United Kingdom

Infertility is an increasingly important issue for patients surviving cancer. Significant improvements in cancer management have led to greater numbers of patients living healthy and fulfilling lives for many years after a diagnosis of cancer, and the ability to bear children is a major component of well-being. Infertility is particularly challenging in gynaecological cancer, where multiple treatment modalities are often employed. Surgery may involve the removal of reproductive organs and subsequent chemotherapy may also lead to infertility. Mitigation of this through the use of cryopreservation of embryos, oocytes or ovarian tissue before chemotherapy may enable subsequent pregnancy in the patient or a surrogate mother. Suppression of ovarian function during chemotherapy is less well established, but promises a reduction in infertility without the risks associated with surgery. Similarly, evolving chemotherapy regimens with replacement of alkylating agents will reduce the incidence of infertility. With a combination of these techniques, an increasing proportion of patients may be able to conceive after completion of treatment, and there is no evidence of an increase in congenital abnormalities. This review discusses chemotherapy-inducedinfertility, interventions and success rates, and demonstrates that individualisation of management is required for optimum outcome.

关键词： Infertility Chemotherapy Gynaecological malignancies Ovarian Cryopreservation

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