女性生育力保存：新興技術(shù)與臨床應(yīng)用

第1章生育力保存的流行病學(xué)………………………………………………………001
TheEpidemiologyofFertilityPreservation
關(guān)于生育力保存的人口統(tǒng)計(jì)資料..................................001
癌癥幸存者生育力的影響因素：概述..............................007
孕后的癌癥復(fù)發(fā)風(fēng)險(xiǎn)............................................009
癌癥幸存者后代的健康風(fēng)險(xiǎn)......................................009
患者對(duì)生育力保存選擇的認(rèn)知度..................................011
醫(yī)療服務(wù)提供者的態(tài)度與認(rèn)知度..................................012
結(jié)語(yǔ)..........................................................013
第2章生育力保存中的倫理討論..................019
EthicalDiscussionsinApproachingFertilityPreservation
倫理原則之概論................................................019
癌癥患者接受生育力保存的倫理問(wèn)題..............................020
知情同意背景下的臨床結(jié)局概要..................................023
結(jié)語(yǔ)..........................................................024
第3章卵泡發(fā)育與生育力保存....................027
OvarianFollicleDevelopmentandFertilityPreservation
哺乳動(dòng)物卵母細(xì)胞與卵泡........................................028
生育力保存之概論..............................................036
結(jié)語(yǔ)..........................................................038

第4章化療和放療對(duì)卵巢的影響..................044
ImpactofChemotherapyandRadiotherapyontheOvary
卵巢的改變....................................................044
卵巢功能評(píng)估..................................................045
育齡期癌癥....................................................047
化療..........................................................047
放療..........................................................052
探討生育問(wèn)題的時(shí)機(jī)............................................055
結(jié)語(yǔ)..........................................................055
第5章化療和放療對(duì)子宮的影響..................059
ImpactofChemotherapyandRadiotherapyontheUterus
正常子宮......................................................059
化療對(duì)子宮的影響..............................................060
輻射對(duì)子宮的影響..............................................060
輻射對(duì)胎盤(pán)形成的影響..........................................062
放療對(duì)妊娠結(jié)局的影響..........................................063
提高生殖功能的潛在機(jī)制........................................069
結(jié)語(yǔ)..........................................................070
第6章卵巢移位..........................073
OvarianTransposition
放療的閾值....................................................073
操作術(shù)式......................................................074
并發(fā)癥........................................................075
生育選擇......................................................076
結(jié)語(yǔ)..........................................................076
第7章生育力保存過(guò)程中的胚胎凍存與控制性超促排卵的可選策略...079
EmbryoCryopreservationandAlternativeControlledOvarianHyperstimulationStrategiesforFertilityPreservation
不孕癥患者凍存—解凍胚胎移植的結(jié)局............................079
凍存技術(shù)......................................................079
生育力保存過(guò)程中的胚胎凍存....................................080
卵巢毒性治療對(duì)生育力的影響....................................080
生育力保存在即將接受放化療的癌癥患者中的應(yīng)用..................081

如何培育惡性腫瘤患者有意凍存的胚胎............................083
相關(guān)法律問(wèn)題..................................................085
卵母細(xì)胞體外成熟..............................................085
凍存胚胎的移植時(shí)機(jī)............................................086
結(jié)語(yǔ)..........................................................087
第8章卵母細(xì)胞冷凍保存......................091
OocyteCryopreservation
卵母細(xì)胞凍存的適應(yīng)證..........................................091
卵母細(xì)胞凍存的患者選擇........................................092
促排卵方案....................................................093
凍存前的卵母細(xì)胞質(zhì)量..........................................094
卵母細(xì)胞凍存的可選方案........................................095
解凍后的卵母細(xì)胞評(píng)估及可能的損傷..............................099
減數(shù)分裂紡錘體的評(píng)估..........................................101
慢速冷凍保存的臨床結(jié)局........................................103
玻璃化冷凍的臨床結(jié)局..........................................103
凍存未成熟卵母細(xì)胞：一種可能的選擇............................105
實(shí)驗(yàn)室要求與安全性............................................105
第9章卵巢組織冷凍保存與自體移植................110
OvarianTissueCryopreservaionandAutotransplantation
基本理論......................................................111
定義..........................................................111
技術(shù)發(fā)展史....................................................112
卵巢皮質(zhì)組織塊與全卵巢移植....................................112
卵巢組織的手術(shù)獲取............................................113
凍存與復(fù)蘇....................................................114
卵巢皮質(zhì)組織塊的自體移植......................................115
全卵巢自體移植................................................116
結(jié)局..........................................................117
風(fēng)險(xiǎn)..........................................................118
第10章卵母細(xì)胞體外成熟：生育力保存之路的難關(guān)........124
OocyteInVitroMaturaion:FormidableObstaclesontheRoadtoFertilityPreservation
卵母細(xì)胞成熟的定義..........................................125

卵母細(xì)胞成熟的歷史回顧......................................126
影響卵母細(xì)胞體外成熟的因素..................................126
未來(lái)研究方向................................................129
第11章全卵巢冷凍保存......................132
WholeOvaryCryopreservation
配子與組織凍存領(lǐng)域的新進(jìn)展..................................132
全卵巢凍存..................................................133
結(jié)語(yǔ)........................................................135
第12章女性惡性腫瘤患者接受凍融卵巢組織移植的風(fēng)險(xiǎn)......139
RiskofTransplantingCryopreservedOvarianTissueinWomenwithMalignancies
卵巢組織冷凍保存技術(shù)在生育力保存中的利弊綜述................140
卵巢組織冷凍保存............................................141
檢測(cè)乳腺癌的轉(zhuǎn)移............................................144
關(guān)于女性乳腺癌患者進(jìn)行卵巢組織凍存的爭(zhēng)議....................146
第13章促性腺激素釋放激素激動(dòng)劑在生育力保存中的作用.....150
Gonadotropin-ReleasingHormoneAgonistsinFertilityPreservaion
GnRH/GnRH受體系統(tǒng)的分布和作用..........................150
應(yīng)用GnRH類(lèi)似物進(jìn)行生育力保存的動(dòng)物研究....................155
使用GnRH激動(dòng)劑進(jìn)行生育力保存的臨床應(yīng)用....................155
GnRH激動(dòng)劑保護(hù)性腺的可能機(jī)制..............................159
結(jié)語(yǔ)........................................................160
第14章婦科惡性腫瘤患者的生育力保存..............165
FertilityPreservationinGynecologicMalignancies....................165
宮頸癌......................................................165
葡萄狀肉瘤..................................................170
卵巢癌......................................................171
浸潤(rùn)性上皮性卵巢癌..........................................173
惡性生殖細(xì)胞腫瘤............................................178
卵巢性索間質(zhì)細(xì)胞腫瘤........................................181
子宮癌......................................................182
子宮內(nèi)膜腺癌................................................183
子宮間質(zhì)腫瘤................................................187
妊娠滋養(yǎng)細(xì)胞疾病............................................193
陰道癌......................................................196
外陰癌......................................................198
結(jié)語(yǔ)........................................................200
第15章癌癥治愈后的第三方輔助生殖和收養(yǎng)：現(xiàn)實(shí)與情感的考量..211
Third-PartyReproductionandAdoptionAfterCancer:PracticalandEmotionalConsiderations
癌癥幸存者為人父母的重要性..................................212
第三方輔助生殖作為癌癥治愈后為人父母的策略..................212
卵母細(xì)胞捐贈(zèng)................................................212
妊娠代孕....................................................215
癌癥治愈后為人父母的另一種策略——收養(yǎng)......................216
結(jié)語(yǔ)........................................................219
第16章妊娠與癌癥治療......................222
PregnancyandCancerTreatment
癌癥發(fā)病率..................................................222
妊娠期癌癥..................................................225
妊娠期癌癥的治療............................................226
化療藥物的常見(jiàn)類(lèi)型..........................................228
放療........................................................230
癌癥治療后的妊娠............................................231
乳腺癌與妊娠................................................233
妊娠滋養(yǎng)細(xì)胞腫瘤............................................234
癌癥復(fù)發(fā)的危險(xiǎn)因素..........................................234
放化療對(duì)男性生育力的影響....................................235
結(jié)語(yǔ)........................................................236
第17章健康女性的生育力保存策略................240
FertilityPreservationStrategiesinHealthyWomen
生育力與年齡................................................240
生育力保存的可選方案........................................241
局限因素與倫理考量..........................................244
患者教育與咨詢(xún)..............................................245
結(jié)論........................................................245
第18章成年女性和青春期前女性的生育力保存方案........249
第19章胚胎冷凍保存和控制性超促排卵的替代策略........260
第20章卵母細(xì)胞冷凍保存.....................265
第21章卵巢組織冷凍保存.....................269