Abstract

Options for fertility preservation (FP) through cryopreservation methods are currently available for young adults, adolescents, and children. Guidelines for FP have been provided by international clinical societies, and emergency procedures aimed at FP have been implemented into clinical practice worldwide. In this article, we review the current data on clinical standards of emergency FP in patients who are facing gonadotoxic effects of cancer treatment, and we also describe the methods that are still under development, usually denoted as experimental. In Sweden, programmes for FP have been established at large university hospitals, thus covering the whole country. The Swedish publicly financed health care covers both assisted reproduction for treatment of infertility and the cryopreservation of gametes or gonadal tissue when there is a medical indication, such as the risk to become infertile due to oncologic treatment; hence the access to FP is ensured for the whole population. At our centre at Karolinska University Hospital in Stockholm, methods for FP have been offered since 1988. In this article, we also review the oncologic indications for FP in our patient cohort of >3000 individuals during the period 1988–2018.

摘要

目前，年轻人，青少年和儿童可以通过冷冻保存方法保存生育力（FP）。国际临床学会已经提供了FP指南，针对FP的应急程序已在全球临床实践中实施。在本文中，我们回顾了面对癌症的性腺毒性作用的患者中紧急FP的临床标准的当前数据，并且我们还描述了仍在开发中的方法，通常称为实验性方法。在瑞典，大型大学医院已经制定了计划生育计划，从而覆盖了整个国家。瑞典的公共资助医疗保健既包括辅助生殖治疗不孕症，也包括在有医学指征（例如由于肿瘤治疗而变得不孕的风险）时冷冻配子或性腺组织的冷冻；因此，确保了整个人口都能使用FP。自1988年以来，在我们位于斯德哥尔摩卡罗林斯卡大学医院的中心，就提供了FP的检测方法。在本文中，我们还回顾了1988-2018年间超过3000名患者的FP的肿瘤学适应症。