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中华妇幼临床医学杂志(电子版)

中华妇幼临床医学杂志(电子版) ›› 2020, Vol. 16 ›› Issue (02) : 150 -154. doi: 10.3877/cma.j.issn.1673-5250.2020.02.005

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乳腺癌患者生育力保存策略研究现状
吴怡媚1, 金丽1, 黄荷凤1,†()   
  1. 1. 上海交通大学医学院附属国际和平妇幼保健院　200030
  • 收稿日期:2020-01-05 修回日期:2020-03-20 出版日期:2020-04-01
  • 通信作者: 黄荷凤

Research status of fertility preservation strategies in breast cancer patients

Yimei Wu1, Li Jin1, Hefeng Huang1,†()   

  1. 1. International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
  • Received:2020-01-05 Revised:2020-03-20 Published:2020-04-01
  • Corresponding author: Hefeng Huang
  • About author:
    Corresponding author: Huang Hefeng, Email:
  • Supported by:
    National Natural Science Foundation of China(81871140)
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吴怡媚, 金丽, 黄荷凤. 乳腺癌患者生育力保存策略研究现状[J]. 中华妇幼临床医学杂志(电子版), 2020, 16(02): 150-154.

Yimei Wu, Li Jin, Hefeng Huang. Research status of fertility preservation strategies in breast cancer patients[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2020, 16(02): 150-154.

乳腺癌是中国女性最高发的恶性肿瘤。随着乳腺癌诊断和治疗手段不断发展，患者总体生存率和无病生存率得到很大提高，育龄期乳腺癌患者的生育需求，也越来越受到关注。乳腺癌化疗、放疗、内分泌治疗过程中，具有不同程度生殖毒性，均可能损害乳腺癌患者的生育力。目前临床常用保存乳腺癌患者生育力策略，包括胚胎和卵母细胞冻存等已较为成熟和完善的生育力保存方式，新兴的卵巢组织冻存、卵子体外成熟(IVM)技术，以及仍然存在争议的化疗期间联用促性腺激素释放激素激动剂(GnRHa)保护卵巢的方案。乳腺癌患者完成治疗后，可以选择合适时机尝试妊娠，并且妊娠并不增加乳腺癌患者复发率和死亡率。笔者拟就乳腺癌治疗对患者生育力的影响、生育力保存策略、妊娠时机和安全性的最新研究进展进行阐述，旨在为临床保存乳腺癌患者生育力提供参考。

关键词: 乳腺肿瘤, 生殖毒性, 生育力保存, 卵子和胚胎冻存, 孵巢组织冻存, 卵子体外成熟, 不育, 女(雌)性

Breast cancer is the most common female malignant tumor in China. Thanks to the continuous development of breast cancer diagnosis and treatments strategies, the overall survival rate and disease-free survival rate have been greatly improved. The fertility demand of breast cancer patients of childbearing age has also received increasing attention. However, the anticancer treatments of breast cancer, such as chemotherapy, radiotherapy, and endocrine therapy, may impair gonadal function and lead to infertility of breast cancer patients. This article outlines current treatments strategies for fertility preservation of breast cancer patients, including the well-established methods such as embryo cryopreservation and oocyte cryopreservation, and the potential alternatives such as ovarian tissue cryopreservation and in vitro maturation (IVM) technique. The application of gonadotropin-releasing hormone agonists (GnRHa) to protect the ovary during chemotherapy is still under controversial. Breast cancer patients can choose the right time to try pregnancy after treatment, and pregnancy does not increase the recurrence rate and mortality of breast cancer patients. This article intends to elaborate on the latest research progresses on the impact of breast cancer treatment on fertility, fertility preservation strategies, timing and safety of pregnancy, and aims to provide references for fertility preservation of breast cancer patients.

Key words: Ovarian neoplasms, Preconception injuries, Fertility preservation, Embryo and oocyte cryopreservation, Ovarian tissue cryopreservation, In vitro maturation of oocyte, Infertility, Female
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