Background: Many cancer treatment methods can affect fertility by damaging the reproductive organs and glands that control fertility. Changes can be temporary or permanent. In order to preserve the fertility of cancer patients and protect the genital organs against gonadotoxicity, methods of fertility preservation are increasingly used. Considering that some patients ultimately decide not to use cryopreserved reproductive material, this review analysed the percentage of post-cancer patients using cryopreserved reproductive material, collected before treatment as part of fertility preservation. Methods: A systematic search of studies was carried out in accordance with the Cochrane Collaboration guidelines, based on a previously prepared research protocol. The search was conducted in Medline (via PubMed), Embase (via OVID), and the Cochrane Library. In addition, a manual search was performed for recommendations/clinical practice guidelines regarding fertility preservation in cancer patients. Results: Twenty-six studies met the inclusion criteria. The studies included in the review discussed the results of cryopreservation of oocytes, embryos, ovarian tissue, and semen. In 10 studies, the usage rate of cryopreserved semen ranged from 2.6% to 21.5%. In the case of cryopreserved female reproductive material, the return/usage rate ranged from 3.1% to 8.7% for oocytes, approx. 9% to 22.4% for embryos, and 6.9% to 30.3% for ovarian tissue. In studies analysing patients’ decisions about unused reproductive material, continuation of material storage was most often indicated. Recovering fertility or death of the patient were the main reasons for rejecting cryopreserved semen in the case of men. Conclusion: Fertility preservation before gonadotoxic treatment is widely recommended and increasingly used in cancer patients. The usage rate is an important indicator for monitoring the efficacy of these methods. In all of the methods described in the literature, this indicator did not exceed 31%. It is necessary to create legal and organizational solutions regulating material collection and storage and to create clear paths for its usage in the future, including by other recipients.
背景：多种癌症治疗方法可能通过损伤控制生育的生殖器官和腺体而影响生育能力，这种影响可能是暂时性或永久性的。为保护癌症患者的生育能力并使其生殖器官免受性腺毒性损害，生育力保存技术的应用日益广泛。鉴于部分患者最终选择不使用冷冻保存的生殖材料，本综述旨在分析癌症患者在治疗前作为生育力保存措施而冷冻保存的生殖材料后续使用率。 方法：根据预先制定的研究方案，遵循Cochrane协作网指南对相关研究进行系统检索。检索范围涵盖Medline（通过PubMed）、Embase（通过OVID）及Cochrane图书馆数据库，同时手工检索了关于癌症患者生育力保存的推荐意见/临床实践指南。 结果：共纳入26项符合标准的研究。这些研究探讨了卵母细胞、胚胎、卵巢组织及精液冷冻保存的结果。在10项涉及精液冷冻的研究中，冷冻精液使用率为2.6%至21.5%。女性生殖材料的使用率方面：卵母细胞为3.1%至8.7%，胚胎约为9%至22.4%，卵巢组织为6.9%至30.3%。在分析患者对未使用生殖材料处置决策的研究中，多数选择继续保存材料。对于男性患者，生育能力恢复或患者死亡是放弃使用冷冻精液的主要原因。 结论：在实施性腺毒性治疗前进行生育力保存已被广泛推荐并越来越多地应用于癌症患者。使用率是评估这些方法有效性的重要指标。文献记载的所有方法中，该指标均未超过31%。有必要建立规范材料采集、储存的法律与组织方案，并为其未来使用（包括其他受体使用）制定明确路径。
肿瘤(癌症)患者之家