女性生育力保存：新兴技术与临床应用

第1章生育力保存的流行病学………………………………………………………001
TheEpidemiologyofFertilityPreservation
关于生育力保存的人口统计资料..................................001
癌症幸存者生育力的影响因素：概述..............................007
孕后的癌症复发风险............................................009
癌症幸存者后代的健康风险......................................009
患者对生育力保存选择的认知度..................................011
医疗服务提供者的态度与认知度..................................012
结语..........................................................013
第2章生育力保存中的伦理讨论..................019
EthicalDiscussionsinApproachingFertilityPreservation
伦理原则之概论................................................019
癌症患者接受生育力保存的伦理问题..............................020
知情同意背景下的临床结局概要..................................023
结语..........................................................024
第3章卵泡发育与生育力保存....................027
OvarianFollicleDevelopmentandFertilityPreservation
哺乳动物卵母细胞与卵泡........................................028
生育力保存之概论..............................................036
结语..........................................................038

第4章化疗和放疗对卵巢的影响..................044
ImpactofChemotherapyandRadiotherapyontheOvary
卵巢的改变....................................................044
卵巢功能评估..................................................045
育龄期癌症....................................................047
化疗..........................................................047
放疗..........................................................052
探讨生育问题的时机............................................055
结语..........................................................055
第5章化疗和放疗对子宫的影响..................059
ImpactofChemotherapyandRadiotherapyontheUterus
正常子宫......................................................059
化疗对子宫的影响..............................................060
辐射对子宫的影响..............................................060
辐射对胎盘形成的影响..........................................062
放疗对妊娠结局的影响..........................................063
提高生殖功能的潜在机制........................................069
结语..........................................................070
第6章卵巢移位..........................073
OvarianTransposition
放疗的阈值....................................................073
操作术式......................................................074
并发症........................................................075
生育选择......................................................076
结语..........................................................076
第7章生育力保存过程中的胚胎冻存与控制性超促排卵的可选策略...079
EmbryoCryopreservationandAlternativeControlledOvarianHyperstimulationStrategiesforFertilityPreservation
不孕症患者冻存—解冻胚胎移植的结局............................079
冻存技术......................................................079
生育力保存过程中的胚胎冻存....................................080
卵巢毒性治疗对生育力的影响....................................080
生育力保存在即将接受放化疗的癌症患者中的应用..................081

如何培育恶性肿瘤患者有意冻存的胚胎............................083
相关法律问题..................................................085
卵母细胞体外成熟..............................................085
冻存胚胎的移植时机............................................086
结语..........................................................087
第8章卵母细胞冷冻保存......................091
OocyteCryopreservation
卵母细胞冻存的适应证..........................................091
卵母细胞冻存的患者选择........................................092
促排卵方案....................................................093
冻存前的卵母细胞质量..........................................094
卵母细胞冻存的可选方案........................................095
解冻后的卵母细胞评估及可能的损伤..............................099
减数分裂纺锤体的评估..........................................101
慢速冷冻保存的临床结局........................................103
玻璃化冷冻的临床结局..........................................103
冻存未成熟卵母细胞：一种可能的选择............................105
实验室要求与安全性............................................105
第9章卵巢组织冷冻保存与自体移植................110
OvarianTissueCryopreservaionandAutotransplantation
基本理论......................................................111
定义..........................................................111
技术发展史....................................................112
卵巢皮质组织块与全卵巢移植....................................112
卵巢组织的手术获取............................................113
冻存与复苏....................................................114
卵巢皮质组织块的自体移植......................................115
全卵巢自体移植................................................116
结局..........................................................117
风险..........................................................118
第10章卵母细胞体外成熟：生育力保存之路的难关........124
OocyteInVitroMaturaion:FormidableObstaclesontheRoadtoFertilityPreservation
卵母细胞成熟的定义..........................................125

卵母细胞成熟的历史回顾......................................126
影响卵母细胞体外成熟的因素..................................126
未来研究方向................................................129
第11章全卵巢冷冻保存......................132
WholeOvaryCryopreservation
配子与组织冻存领域的新进展..................................132
全卵巢冻存..................................................133
结语........................................................135
第12章女性恶性肿瘤患者接受冻融卵巢组织移植的风险......139
RiskofTransplantingCryopreservedOvarianTissueinWomenwithMalignancies
卵巢组织冷冻保存技术在生育力保存中的利弊综述................140
卵巢组织冷冻保存............................................141
检测乳腺癌的转移............................................144
关于女性乳腺癌患者进行卵巢组织冻存的争议....................146
第13章促性腺激素释放激素激动剂在生育力保存中的作用.....150
Gonadotropin-ReleasingHormoneAgonistsinFertilityPreservaion
GnRH/GnRH受体系统的分布和作用..........................150
应用GnRH类似物进行生育力保存的动物研究....................155
使用GnRH激动剂进行生育力保存的临床应用....................155
GnRH激动剂保护性腺的可能机制..............................159
结语........................................................160
第14章妇科恶性肿瘤患者的生育力保存..............165
FertilityPreservationinGynecologicMalignancies....................165
宫颈癌......................................................165
葡萄状肉瘤..................................................170
卵巢癌......................................................171
浸润性上皮性卵巢癌..........................................173
恶性生殖细胞肿瘤............................................178
卵巢性索间质细胞肿瘤........................................181
子宫癌......................................................182
子宫内膜腺癌................................................183
子宫间质肿瘤................................................187
妊娠滋养细胞疾病............................................193
阴道癌......................................................196
外阴癌......................................................198
结语........................................................200
第15章癌症治愈后的第三方辅助生殖和收养：现实与情感的考量..211
Third-PartyReproductionandAdoptionAfterCancer:PracticalandEmotionalConsiderations
癌症幸存者为人父母的重要性..................................212
第三方辅助生殖作为癌症治愈后为人父母的策略..................212
卵母细胞捐赠................................................212
妊娠代孕....................................................215
癌症治愈后为人父母的另一种策略——收养......................216
结语........................................................219
第16章妊娠与癌症治疗......................222
PregnancyandCancerTreatment
癌症发病率..................................................222
妊娠期癌症..................................................225
妊娠期癌症的治疗............................................226
化疗药物的常见类型..........................................228
放疗........................................................230
癌症治疗后的妊娠............................................231
乳腺癌与妊娠................................................233
妊娠滋养细胞肿瘤............................................234
癌症复发的危险因素..........................................234
放化疗对男性生育力的影响....................................235
结语........................................................236
第17章健康女性的生育力保存策略................240
FertilityPreservationStrategiesinHealthyWomen
生育力与年龄................................................240
生育力保存的可选方案........................................241
局限因素与伦理考量..........................................244
患者教育与咨询..............................................245
结论........................................................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章胚胎冷冻保存和控制性超促排卵的替代策略........260
第20章卵母细胞冷冻保存.....................265
第21章卵巢组织冷冻保存.....................269