امیدهای تازه در حفظ باروری زنان مبتلا به سرطان (یک مقاله مروری)
محورهای موضوعی : زیست شناسی سلولی تکوینی گیاهی و جانوری ، تکوین و تمایز ، زیست شناسی میکروارگانیسم
سیده فاطمه سیادت
1
(گروه زیست شناسی، دانشکده علوم زیستی، واحد تهران شمال، دانشگاه آزاد اسلامی، تهران، ایران)
روح الله فتحی
2
(گروه جنین شناسی ، مرکز تحقیقات پزشکی تولید مثل،پژوهشکده زیست شناسی و علوم پزشکی تولید مثل جهاد دانشگاهی، پژوهشگاه رویان، تهران، ایران)
کلید واژه: سرطان, حفظ باروری, انجماد و پیوند تخمدان, گناد مصنوعی, سلول های بنیادی تخمدان,
چکیده مقاله :
پیشرفت های اخیر در تشخیص و درمان سرطان نظیر رادیوتراپی و شیمی درمانی و پیوند مغز استخوان امید به زندگی را در این بیماران افزایش داده است. مواد سمی و تشعشعات یونیزان، باعث تهدید فعالیت آندوکرین و چرخه تولید مثلی، از دست دادن باروری و نارسایی زودرس تخمدان (POF) می شود. روش های رایج در درمان این افراد شامل جابجایی تخمدان، انجماد جنین و تخمک و انجماد و پیوند بافت تخمدان است. انجماد جنین و تخمک نیاز به تحریکات هورمونی برای افزایش تعداد تخمک ها دارد اما آغاز درمان سرطان را به تاخیر انداخته و مستقیما باعث پیشرفت تومورهای وابسته به هورمون می شود. از طرفی در انجماد جنین نیاز به شریک جنسی (همسر یا فرد دهنده اسپرم) است و در دختران جوان و کودکان قابل دسترسی نیست. به همین دلیل در بیماران جوان به منظور حفظ باروری انجماد بافت تخمدان و سپس پیوند آن کاربردی تر است. تا کنون روش های مختلفی در پیوند تخمدان بر روی گونه های مختلف جانوری و انسان انجام گرفته است. هر کدام از این روش ها دارای مزایا و معایبی است.. با وجود این هنوز مسائل حل نشده بسیاری در زمینه حفظ باروری در بیماران مبتلا به سرطان باقی مانده است. از طرفی نیز دریچه های امیدی در حفظ باروری افراد سرطانی رو به آینده گشوده شده است. هدف در این مطالعه به روز رسانی تحقیقات انجام شده در مورد استراتژی های حفظ باروری بوده و بدین منظور خلاصه ای از پیشرفت های حاصل شده در این زمینه ارائه شده است.
Recent advances in cancer diagnosis and treatment such as radiotherapy, chemotherapy and bone marrow transplantation have increased life expectancy in these patients. Toxic substances and ionizing radiation threaten endocrine activity and reproductive cycle, causing loss of fertility and early ovarian failure (POF). Common approaches to treating fertility include ovarian Oophoropexy, oocyte and embryo freezing, and freezing of ovarian tissue and transplantation. Cryopreservation of the embryo and oocyte requires hormonal stimuli to increase the number of eggs, but delay the onset of cancer treatment and directly contribute to the development of hormone-dependent tumors. On the other hand, in the freezing of the embryo, there is a need for a sexual partner (the wife or sperm donor) and is not accessible to young girls and children. For this reason, in young patients, in order to preserve fertilization, ovarian tissue cultures and then transplantation are more useful. So far, various methods have been used in ovarian transplantation on different animal and human species. Each of these methods has some advantages and disadvantages. However, many unresolved issues remain with regard to maintaining fertility in cancer patients. On the other hand, hopefuls have been opened to preserve the fertility of cancer patients. The purpose of this study is to update the research on fertility preservation strategies and to summarize the progress made in this regard.
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