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Fertility preservation options in breast cancer patients.

机译:乳腺癌患者的生育力保留选择。

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摘要

The purpose of this review is to analyse current options for fertility preservation in young women with breast cancer (BC). Considering an increasing number of BC survivors, owing to improvements in cancer treatment and delaying of childbearing, fertility preservation appears to be an important issue. Current fertility preservation options in BC survivors range from well-established standard techniques to experimental or investigational interventions. Among the standard options, random-start ovarian stimulation protocol represents a new technique, which significantly decreases the total time of the in vitro fertilisation cycle. However, in patients with oestrogen-sensitive tumours, stimulation protocols using aromatase inhibitors are currently preferred over tamoxifen regimens. Cryopreservation of embryos and oocytes are nowadays deemed the most successful techniques for fertility preservation in BC patients. GnRH agonists during chemotherapy represent an experimental method for fertility preservation due to conflicting long-term outcome results regarding its safety and efficacy. Cryopreservation of ovarian tissue, in vitro maturation of immature oocytes and other strategies are considered experimental and should only be offered within the context of a clinical trial. An early pretreatment referral to reproductive endocrinologists and oncologists should be suggested to young BC women at risk of infertility, concerning the risks and benefits of fertility preservation options.
机译:这篇综述的目的是分析乳腺癌(BC)的年轻女性保留生育能力的当前选择。考虑到越来越多的BC幸存者,由于癌症治疗的改善和生育的延迟,生育力的保持似乎是一个重要问题。目前,卑诗省幸存者的生育能力选择范围从公认的标准技术到实验或研究干预措施不等。在标准选项中,随机启动卵巢刺激方案代表了一种新技术,该技术显着减少了体外受精周期的总时间。但是,在患有雌激素敏感性肿瘤的患者中,目前比使用他莫昔芬方案更优选使用芳香酶抑制剂的刺激方案。如今,冷冻保存胚胎和卵母细胞被认为是不列颠哥伦比亚省最成功的保存生育力的技术。化疗期间的GnRH激动剂代表了一种保存生育力的实验方法,因为有关其安全性和功效的长期结果相互矛盾。卵巢组织的冷冻保存,未成熟卵母细胞的体外成熟和其他策略被认为是实验性的,应仅在临床试验范围内提供。应建议生育前内分泌科医生和肿瘤科医生尽早转诊至面临生育风险的卑诗省年轻女性,考虑保留生育方法的风险和益处。

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