在化疗前的生育保护周期中,长期作用的淋巴激素释放激素激素激活剂触发了化疗前的生育保护周期
C Massarotti1, S Stigliani2, I Gazzo1
1Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI Department), University of Genoa, Genoa; Maternal and Child Department, Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa.
ESMO open
|July 8, 2023
概括
长效的淋巴激素释放激素激动剂 (GnRHa) 有效地触发卵细胞成熟,以保护癌症患者的生育能力. 这种方法可以降低卵巢过度刺激综合征 (OHSS) 的风险,并在化疗前确保卵巢抑制.
科学领域:
- 生殖内分泌学 生殖内分泌学
- 在瘤学瘤学.
- 保护生育能力 保护生育能力
背景情况:
- 卵细胞/胚胎冷保存和卵巢功能抑制是癌症患者的关键生育保存方法.
- 淋巴激素释放激素激动剂 (GnRHas) 用于卵巢抑制,通常在受控卵巢刺激 (COS) 的状阶段启动.
- GnRHa的爆发效应可以增加卵巢过度刺激综合征 (OHSS) 的风险,阻止其使用.
研究的目的:
- 评估长期作用的GnRHa在瘤患者的卵细胞检索中作为排卵触发剂的疗效.
- 在使用长效GnRHa用于生育保存时评估OHSS和卵巢抑制的风险.
主要方法:
- 对从2016年至2021年在接受COS进行卵细胞冷保存的癌症患者中前性收集的数据进行回顾性分析.
- 长效GnRHa触发剂的比较 (2020年以来) 与人类胆管性腺激素或短效GnRHa触发剂的比较 (对照).
- 收集了关于卵细胞成熟率,冷保存卵细胞产量和OHSS发生率的数据.
主要成果:
- 用长效GnRHa触发的所有22个周期都导致成熟的卵细胞收集,成熟率为80%.
- 平均冷保存的卵细胞:长效GnRHa11.1±4,与8.8±5.8 (hCG) 和14±8.4 (短效GnRHa) 相比.
- 长期作用的GnRHa没有观察到OHSS病例;在检索后5天内实现了氨化激素抑制.
结论:
- 长效的GnRHa在诱导癌症患者最终卵细胞成熟方面是有效的.
- 与传统触发器相比,这种方法显著降低了OHSS的风险.
- 长效的GnRHa可确保在接受化疗的患者及时抑制卵巢.
相关概念视频
In Vitro Fertilization
334
In vitro fertilization (IVF) is a form of assisted reproductive technology where an egg is fertilized with sperm in a controlled laboratory environment before transferring the resulting embryo into the uterus. This process is designed to help individuals and couples experiencing difficulties conceiving.
The IVF process begins with ovarian stimulation, during which reproductive endocrinologists prescribe hormonal medications to stimulate the ovaries to produce multiple eggs instead of the single...
The IVF process begins with ovarian stimulation, during which reproductive endocrinologists prescribe hormonal medications to stimulate the ovaries to produce multiple eggs instead of the single...
334
Infertility in Females
353
Female infertility is defined as the inability to conceive after a year of regular, unprotected intercourse and affects about 10–15% of couples worldwide. The primary cause of female infertility is ovulatory disorders, which hinder the release of eggs. These disorders can be classified as hypothalamic amenorrhea, polycystic ovarian syndrome (PCOS), premature ovarian failure, and hyperprolactinemic anovulation disorders.
Endometriosis, a condition characterized by abnormal growth of...
Endometriosis, a condition characterized by abnormal growth of...
353
Chemotherapy-Induced Nausea and Vomiting: 5-HT3 Receptor Antagonists
249
5-HT3 receptor antagonists, such as dolasetron, granisetron (Kytril), ondansetron (Zofran), and palonosetron (Axoli), are crucial in managing chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea. These drugs selectively block 5-HT3 receptors in the visceral vagal and spinal afferent nerves, chemoreceptor trigger zone, and the vomiting center. They have a rapid onset of action and can be given as a single dose before chemotherapy. Ondansetron and granisetron, in particular,...
249
Hormonal Control of the Ovarian Cycle
586
The ovarian cycle is meticulously regulated by the hypothalamic-pituitary-gonadal axis. This cycle orchestrates the release of a mature oocyte, essential for reproduction.
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
Before puberty, the hypothalamus releases GnRH in a low frequency, low amplitude pulsatile manner. This along with the immature hypothalamic-pituitary-gonadal axis activity, results in low estrogen levels and the absence of a fully functional ovarian cycle. At puberty, GnRH secretion increases in both frequency and...
586
Infertility in Males
299
Male infertility affects millions of couples worldwide, arising from various factors that impact different stages of the reproductive process. An endocrine imbalance resulting from conditions like hypogonadism, Klinefelter syndrome, or pituitary disorders can disrupt hormone levels and reduce sperm production. Testicular defects, such as tumors, cryptorchidism, atrophic testes, abnormal sperm morphology, and low sperm count or motility, may arise due to genetic factors, structural...
299
Ovarian Cycle
1.4K
The menstrual cycle includes a critical component known as the ovarian cycle, which undergoes two main phases each month—the follicular phase and the luteal phase. The follicular phase is variable and averaging around 14 days. Ovulation, triggered by a surge in luteinizing hormone (LH), marks the transition between the two phases. The second phase, the luteal phase, is relatively consistent, lasting approximately 14 days, and is marked by the activity of the corpus luteum. While a cycle...
1.4K


