Medicina, Vol. 43. No. 4., 2007.
Ostalo
FERTILITY PRESERVATION, ASSISTED REPRODUCTION AND MALIGNANT DISEASE
Ozren Mamula
; Klinika za ginekologiju i porodništvo, KBC Rijeka, Hrvatska
Neda Smiljan Severinski
; Katedra za ginekologiju i opstetriciju, Medicinski fakultet Sveučilišta u Rijeci, Hrvatska
Herman Haller
; Klinika za ginekologiju i porodništvo, KBC Rijeka, Hrvatska
Sažetak
abstract
Aim: To show modern aproach in perserving fertility
during cancer treatment, modern methods in use and
their clinical value.
Methods: Systematic review of the literature from 1987
to 2005 was performed including a search of online
databases to study modern aproach in perserving fertility
during cancer treatment, methods in use and their
clinical value, and possibility of their implementation
regarding our current conditiones.
Results: Malignat disease is becoming more common in
population of young women and survival rate is higher.
At the same time, birth incidence is shifted to the older
women population when the incidence of the cancer is
increast. Malignant disease and its treatment may result
in decreast fertility, which depends on many factors like:
drug or size/location of the radiation field, dose, doseintensity,
method of administration (oral versus intravenous), disease, age, sex and pretreatment fertility of the
patient. To preserve the full range of options, fertility
preservation approaches should be considered as early as
possible during treatment planning. Sperm cryopreservation
and embryo cryopreservation are the two most
successful methods in perserving fertility. Conservative
surgical approach and transposition of ovaries outside
radiation field may also perserve fertility during treatment
of some cancers. At the time, all other methods
should be considered investigational. Although the data
is limited, it seems that there is no increased risk of disease
recurrence connected with the method of fertility
perservation or pregnancy. There is no evidence that
malignant disease, its treatment or methods of perserving
fertility increase the risc of congenital anomalies in
the progeny.
Conclusion: Sperm cryopreservation in men and embryo
cryopreservation in women are the most successful
methods of perserving fertility in men and women
undergoing treatment for cancer. Development of guidelines
thogether with quality legal solutions are crucial
for their implementation on the national level.
Ključne riječi
malignant disease; perserving fertility; methods of assisted reproduction; IVF
Hrčak ID:
23480
URI
Datum izdavanja:
20.12.2007.
Posjeta: 4.006 *