Author: Ephia Yasmin and Melanie C. Davies
做者：Ephia Yasmin and Melanie C. Davies
Book: Pregnancy After Assisted Reproductive Technology
册本：帮助死殖手艺下的怀胎
Published by: Cambridge University Press
出书社：剑桥年夜教出书社
Editors: Botros R.M.B. Rizk
Eric R.M. Jauniaux
主编：Botros RMB Rizk
Eric R.M. Jauniaux
Fertility preservation is primarily considered for men and women in the reproductive age group, but also for children and adolescents where the condition and/or treatment are/is likely to render them infertile. The need for fertility preservation is increasing because of more cancer survivors and improved prognosis of treatment of cancers.生养才能的保存合用工具次要是育龄囊僧，但也合用于果一些情况或医治能够使其没有育的女童战青少年。癌症幸存者的增长战癌症医治预后的改进，使凳茭育力保存的需供也不竭增长。
The risk of infertility is generally related to the tissues or organs involved in the cancer and the specific treatment used. Surgery and radiotherapy have local effects. Chemotherapy causes depletion of the ovarian pool of follicles. (1) The severity of damage depends on the dose, age of patient, and type of cytotoxic agent used. Increasing age makes women more vulnerable to loss of ovarian function compared with younger patients.没有孕没有育风险凡是取癌症所进犯的构造或器民和其详细的医治方法庸呢。脚术战放射医治具有部分效应。化疗会耗损滤纵基数池（数据参考睹1）。耗损水平取细胞毒素济骺、患者年齿战细胞毒素的范例庸呢。取年青患者比拟，跟着年齿的增长，年夜龄女性更简单损失卵巢功用。
Most chemotherapeutic drugs affect mainly the dividing cells such as granulosa and theca cells. The most cytotoxic agents are alkylating agents such as cyclophosphamide, which compromises ovarian reserve. (2) Resulting amenorrhea may be temporary or permanent. It has been suggested that destruction of maturing follicles causes temporary amenorrhea while destruction of primordial follicles causes permanent amenorrhea. (3) Depending on the nature of chemotherapy and age at chemotherapy, menstrual function and fertility may return variably after the cessation of therapy in the case of temporary damage to the ovarian follicles. (4)年夜大都化疗药物次要影响正正在团结当备胞，如颗粒细胞战滤纵膜细胞。最具细胞毒性的药物是烷化剂，如环磷酰敖爆它会损伤卵巢储蓄功用（数据参考睹2）。化疗酿成的闭经多是临时或永世的。幼硇究者以为，成生滤纵的毁坏会招致临时性闭经，而本初滤纵的毁坏则会招致永世性闭经（数据参考睹3）。按照化疗性子战化疗时年齿的差别，正在滤纵临时受益的状况下，截至医治后，月经功用战生养力能够会有差别水平的规复（数据参考睹4）。
The testis is very sensitive to the detrimental effects of chemotherapy at any age. The germinal epithelium is more sensitive than the Leydig cells, and therefore oligospermia and azoospermia occur even if testosterone production continues.不管正在任何年岁，卣借对化疗的有害影响皆十分敏感。死殖上皮细胞比卣借间量细胞更敏感，因而即便卣姜连续发生，颐挥嗅呈现少粗症战无粗症的状况。
References 数据参考：1. Schilsky RL, Lewis BJ, Sherins RJ, Young RC. Gonadal dysfunction in patients receiving chemotherapy for cancer. Ann Intern Med 1980; 109-1142. Nicosia SV, Matus-Ridley M, Meadows AT. Gonadal effects of cancer therapy in girls. Cncer 1985;55:2364-23723. Falcone T, Attaran M, Bedaiwy MA, Goldberg JM. Ovarian function preservation in the cancer patient. Fertil Steril 2004;81:243-2574. Minisini AM, Menis J, Valent F, et al. Determinants of recovery from amenorrhea in the premenopausal breast cancer patients receiving adjuvant chemotherapy in the taxane ear. Anticancer Drugs 2009; 20:503-507
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