Современные возможности сохранения фертильности у пациенток молодого возраста. Взгляд онколога
https://doi.org/10.18027/2224-5057-2024-14-3s1-42-48
Abstract
В последние годы в онкологии с внедрением новых методов комплексного лечения отмечается значительное увеличение продолжительности жизни пациентов. При этом большинство используемых методов лечения потенциально гонадотоксичны и приводят к преждевременной недостаточности яичников, и соответственно к потере фертильности и способности к деторождению у молодых женщин. На момент постановки диагноза все больше пациенток задают вопросы о снижающим фертильность действии лекарственной терапии, радиотерапии, хирургических вмешательств. Недостаточная информированность онкологов и незаинтересованность в изучении вопросов, связанных с потерей репродуктивной функции, нежелание обсуждать вопросы репродукции и после лечения, приводят к психологическому стрессу и зачастую к отказу от предлагаемых вариантов терапии. Целью данной статьи является информирование онкологов о современных методах сохранения фертильности для возможности проведения ознакомительной беседы с пациентками молодого возраста перед планируемым лечением.
About the Author
А. Пароконная
ФГБУ «Национальный медицинский исследовательский центр онкологии им. Н. Н. Блохина» Минздрава России
Russian Federation
Russian Federation
References
1. Lambertini M., Peccatori F.A., Demeestere I. et.al. Fertility preservation and post-treatment pregnancies in post-pubertal cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol 2020;31(12):1664-1678. https://doi.org/10.1016/j.annonc.2020.09.006
2. Anderson R., Amant F., Braat D. et.al. ESHRE guideline: female fertility preservation. Hum Reprod Open 2020;2020(4):hoaa052. https://doi.org/10.1093/hropen/hoaa052
3. Oktay K., Harvey B.E., Partridge A.H., et al. Fertility preservation in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol 2018;36(19):1994-2001. https://doi.org/10.1200/JCO.2018.78.1914
4. Michalczyk K., Cymbaluk-Ploska A. Fertility preservation and long-term monitoring of gonadotoxicity in girls, adolescents and young adults undergoing cancer treatment. Cancers (Basel) 2021;13(2):202. https://doi.org/10.3390/cancers13020202
5. Higdon R.E., Marchetti F., Mailhes J.B., Phillips G.L. The effects of cisplatin on murine metaphase II oocytes. Gynecol Oncol 1992;47(3):348-352. https://doi.org/10.1016/0090-8258(92)90138-9
6. Del-Pozo-Lerida S., Salvador C., Martinez-Soler F., et al. Preservation of fertility in patients with cancer (Review). Oncol Rep 2019;41(5):2607-2614. https://doi.org/10.3892/or.2019.7063
7. Roness H., Kalich-Philosoph L., Meirow D. Prevention of chemotherapyinduced ovarian damage: Possible roles for hormonal and nonhormonal attenuating agents. Hum Reprod Update 2014;20(5):759-774. https://doi.org/10.1093/humupd/dmu019
8. Lee S.J., Schover L.R., Partridge A.H., et al. American society of clinical oncology recommendations on fertility preservation in cancer patients. J Clin Oncol 2006;24(18):2917-2931. https://doi.org/10.1200/JCO.2006.06.5888
9. Wang Y., Li Y., Liang J., et al. Chemotherapy-induced amenorrhea and its prognostic significance in premenopausal women with breast cancer: An updated meta-analysis. Front Oncol 2022;12. https://doi.org/10.3389/fonc.2022.859974
10. Ganz P.A., Land S.R., Geyer Jr C.E., et al. Menstrual history and qualityoflife outcomes in women with nodepositive breast cancer treated with adjuvant therapy on the NSABP B30 trial. J Clin Oncol 2011;29(9):1110—1116. https://doi.org/10.1200/JCO.2010.29.7689
11. Lambertini M., Ceppi M., Anderson R., et al. Impact of anti-HER2 therapy alone and with weekly paclitaxel on the ovarian reserve of young women with HER2-positive breast cancer. JNCCN 2023;21(1):33-41. https://doi.org/10.6004/jnccn.2022.7065
12. Winship A.L., Alesi L.R., Sant S., et al. Checkpoint inhibitor immunotherapy diminishes oocyte number and quality in mice. Nat Cancer 2022;3(8):1-13. https://doi.org/10.1038/s43018-022-00413-x
13. Bines J., Oleske D.M., Cobleigh M.A. Ovarian function in premenopausal women treated with adjuvant chemotherapy for breast cancer. J Clin Oncol 1996;14(5):1718-1729. https://doi.org/10.1200/JCO.1996.14.5.1718
14. Wallace W.H.B., Anderson R.A., Irvine D.S. Fertility preservation for young patients with cancer: who is at risk and what can be offered? Lancet Oncol 2005;6(4):209-218. https://doi.org/10.1016/S1470-2045(05)70092-9
15. Walshe J.M., Denduluri N., Swain S.M. Amenorrhea in premenopausal women after adjuvant chemotherapy for breast cancer. J Clin Oncol 2006;24(36):5769-5779. https://doi.org/10.1200/JCO.2006.07.2793
16. Goodwin P.J., Ennis M., Pritchard K.I., et al. Risk of menopause during the first year after breast cancer diagnosis. J Clin Oncol 1999;17(8):2365-2370. https://doi.org/10.1200/JCO.1999.178.2365
17. Petrek J.A., Naughton M.J., Case L.D., et al. Incidence, time course, and determinants of menstrual bleeding after breast cancer treatment: aprospective study. J Clin Oncol 2006;24(7):1045-1051. https://doi.org/10.1200/JCO.2005.03.3969
18. Lee S., Kil W.J., Chun M., et al. Chemotherapy-related amenorrhea in premenopausal women with breast cancer. Menopause 2009;16(1):98-103. https://doi.org/10.1097/gme.0b013e3181844877
19. Ribi K., Luo W., Bernhard J., et al. Adjuvant tamoxifen plus ovarian function suppression versus tamoxifen alone in premenopausal women with early breast cancer: patient-reported outcomes in the suppression of ovarian function trial. J Clin Oncol 2016;34(14):1601-1610. https://doi.org/10.1200/JCO.2015.64.8675
20. Wallace W.H.B., Thomson A.B., Saran F., Kelsey T.W. Predicting age of ovarian failure after radiation to a field that includes the ovaries. Int J Radiat Oncol Biol Phys 2005;62(3):738-744. https://doi.org/10.1016/j.ijrobp.2004.11.038
21. Larsen E.C., Schmiegelow K., Rechnitzer C., et al. Radiotherapy at a young age reduces uterine volume of childhood cancer survivors. Acta Obstet Gynecol Scand 2004;83(1):96-102. https://doi.org/10.1111/j.1600-0412.2004.00332.x
22. Wallace W.H.B., Shalet S.M., Hendry J.H. et.al. Ovarian failure following abdominal irradiation in childhood: The radiosensitivity of the human oocyte. Br J Radiol 1989;62(743):995-998. https://doi.org/10.1259/0007-1285-62-743-995
23. Titus S., Li F., Stobezki R., et al. Impairment of BRCA1-related DNA double-strand break repair leads to ovarian aging in mice and humans. Sci Transl Med 2013;5(172):172ra21. https://doi.org/10.1126/scitranslmed.3004925
24. Govindaraj V., Keralapura Basavaraju R., Rao A.J. Changes in the expression of DNA double strand break repair genes in primordial follicles from immature and aged rats. Reprod Biomed Online 2015;30(3):303-310. https://doi.org/10.1016/j.rbmo.2014.11.010
25. Stolk L., Perry J.R.B., Chasman D.I., et al. Meta-analyses identify 13 loci associated with age at menopause and high-light DNA repair and immune pathways. Nat Genet 2012;44(3):260-268. https://doi.org/10.1038/ng.1051
26. Day F.R., Ruth K.S., Thompson D.J., et al. Large-scale genomic analyses link reproductive aging to hypothalamic signaling, breast cancer susceptibility and BRCA1-mediated DNA repair. Nat Genet 2015;47(11):1294-1303. https://doi.org/10.1038/ng.3412
27. Loren A.W., Mangu P.B., Beck L.N. et.al. Fertility Preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol 2013;31(19):2500-10. https://doi.org/10.1200/JCO.2013.49.2678
28. Peccatori F.A., Azim Jr H.A., Orecchia R. et.al. Cancer, pregnancy and fertility: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013;24 Suppl 6:vi160-70. https://doi.org/10.1093/annonc/mdt199
29. Gook D.A., Edgar D.H. Human oocyte cryopreservation. Hum Reprod Update 2007;13(6):591-605. https://doi.org/10.1093/humupd/dmm028
30. Tian Y., Liang Y., Yang X. Successful delivery after in vitro fertilization-embryo transfer in a woman with metachro-nous primary cancer of ovary and endometrium: A case report. BMC Pregnancy Childbirth 2023;23(1):677.
31. Porcu E., Cipriani L., Dirodi M., et al. Successful pregnancies, births, and children development following oocyte cryostorage in female cancer patients during 25 years of fertility preservation. Cancers (Basel) 2022;14(6):1429. https://doi.org/10.3390/cancers14061429
32. Arecco L., Blondeaux E., Bruzzone M., et al. Safety of fertility preservation techniques before and after anticancer treatments in young women with breast cancer: a systematic review and meta-analysis. Hum Reprod. 2022 May 3;37(5):954-968. https://doi.org/10.1093/humrep/deac035
33. Goldrat O., Demeestere I., Azim H. A Jr. Response to ‘Is it safe to perform a controlled ovarian stimulation for assisted reproduction in young breast cancer survivors?'. Eur J Cancer 2016;54:165-166. https://doi.org/10.1016/j.ejca.2015.10.002
34. Arecco L., Blondeaux E., Bruzzone M. et.al. Safety of fertility preservation techniques before and after anticancer treatments in young women with breast cancer: a systematic review and meta-analysis. Hum Reprod 2022;37(5):954-968. https://doi.org/10.1093/humrep/deac035
35. Oktay K., Demirtas E., Son W.-Y. et.al. In vitro maturation of germinal vesicle oocytes recovered after premature lu-teinizing hormone surge: description of a novel approach to fertility preservation. Fertil Steril 2008;89(1):228.e19-22. https://doi.org/10.1016/j.fertnstert.2007.02.028
36. Condorelli M., Bruzzone M., Ceppi M., et al. Safety of assisted reproductive techniques in young women harboring germline pathogenic variants in BRCA1/2 with a pregnancy after prior history of breast cancer. ESMO Open 2021;6(6):100300. https://doi.org/10.1016/j.esmoop.2021.100300
37. Wallace W.H.B., Smith A.G., Kelsey T.W. et.al Fertility preservation for girls and young women with cancer: population-based validation of criteria for ovarian tissue cryopreservation. Lancet Oncol 2014;15(10):1129-36.
38. Meirow D., Ra'anani H., Biderman H. Ovarian tissue cryopreservation and transplantation: a realistic, effective technology for fertility preservation. Methods Mol Biol 2014;1154:455-73. https://doi.org/10.1007/978-1-4939-0659-8_21
39. Oktay K. Evidence for limiting ovarian tissue harvesting for the purpose of transplantation to women younger than 40 years of age. J Clin Endocrinol Metab 2002;87(4):1907-8. https://doi.org/10.1210/jcem.87.4.8367
40. Dolmans M.M., von Wolff M., Poirot C., et al. Transplantation of cryopreserved ovarian tissue in a series of 285 women: A review of five leading European centers. Fertil Steril 2021;115(5):1102-15. https://doi.org/10.1016/j.fertnstert.2021.03.008
41. Glode L.M., Robinson J., Gould S.F. Protection from cyclophosphamide-induced testicular damage with an analogue of gonadotropin-releasing hormone. Lancet 1981;1(8230):1132-1134. https://doi.org/10.1016/s0140-6736(81)92301-1
42. Lambertini M., Moore H.C.F., Leonard R.C.F., et al. Gonadotropin-releasing hormone agonists during chemotherapy for preservation of ovarian function and fertility in premenopausal patients with early breast cancer: A systematic review and meta-analysis of individual patient-level data. J Clin Oncol 2018;36(19):1981-1990. https://doi.org/10.1200/JCO.2018.78.0858.
Review
For citations:
. Malignant tumours. 2024;14(3s1):42-48. (In Russ.) https://doi.org/10.18027/2224-5057-2024-14-3s1-42-48
Views:
117
Email this article 