Blumenfeld Zeev, Evron Ayelet
Reproductive Endocrinology, Rappaport Faculty of Medicine, Rambam Health Care Campus, Technion-Israel Institute of Technology, Haifa, Israel.
Curr Opin Obstet Gynecol. 2016 Aug;28(4):223-9. doi: 10.1097/GCO.0000000000000278.
Fertility preservation has recently gained a worldwide interest among fertility specialists, oncologists, and all healthcare providers. Thus, the protection against iatrogenic infertility caused by chemotherapy assumes a high priority. Specifically, the issue of endocrine prevention of gonadotoxicity is still a controversial subject.
During the last year, many publications on this subject appeared, swinging the pendulum toward the beneficial role of gonadotropin-releasing hormone agonist (GnRHa) cotreatment for fertility preservation despite gonadotoxic chemotherapy. Here, we summarize the recent publications on fertility preservation and minimizing chemotherapy-induced gonadotoxicity.
More than 10 recent meta-analyses have concluded that GnRHa is beneficial and may decrease the risk of premature ovarian failure and increase the pregnancy rate in survivors. Furthermore, two recent international meetings of experts have concluded that GnRHa is effective and should be offered to every young woman facing gonadotoxic chemotherapy.
生育力保存最近在生育专家、肿瘤学家及所有医疗服务提供者中引起了全球关注。因此,预防化疗所致医源性不孕成为当务之急。具体而言,性腺毒性的内分泌预防问题仍是一个有争议的话题。
去年,关于该主题的众多出版物问世,尽管存在性腺毒性化疗,但使促性腺激素释放激素激动剂(GnRHa)联合治疗在生育力保存中的有益作用成为主流观点。在此,我们总结近期关于生育力保存及将化疗所致性腺毒性降至最低的出版物。
最近10多项荟萃分析得出结论,GnRHa有益,可能降低卵巢早衰风险并提高幸存者的妊娠率。此外,最近两次国际专家会议得出结论,GnRHa有效,应提供给每一位面临性腺毒性化疗的年轻女性。