Защита яичников перед гонадотоксичной терапией – проблема онкологии и репродуктивной медицины
Противоопухолевая химиотерапия является одним из основных методов лечения онкологических заболеваний. При этом, помимо высокой эффективности, она обладает гонадотоксичным действием, ухудшающим качество жизни пациенток, основная часть которых находится в репродуктивном возрасте на момент постановки диагноза. В обзор включены данные российских и зарубежных статей, опубликованных в базе данных PubMed за последние 5 лет. Для снижения патологического влияния противоопухолевой терапии на яичники используется несколько категорий препаратов (агонисты гонадотропин-рилизинг-гормона, оральные контрацептивы в непрерывном режиме). Эффективность этих препаратов в отношении сохранения репродуктивной и эндокринной функций яичников на настоящий момент не доказана. Именно поэтому сейчас ведется поиск новых средств для защиты яичников. Известно, что степень повреждения овариального резерва во время лечения, а также эффективность защиты яичников зависят от множества факторов. Тем не менее даже для уже существующих препаратов не разработано критериев и тактики назначения.Дмитриева И.Е., Назаренко Т.А., Хохлова С.В.
Заключение. Данный обзор научной литературы показывает необходимость оценки клинической значимости используемых методов защиты яичников и разработки новых подходов.
Ключевые слова
онкофертильность
защита яичников
сохранение фертильности
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Поступила 12.08.2020
Принята в печать 20.10.2020
Об авторах / Для корреспонденции
Дмитриева Ирина Евгеньевна, аспирантка, ФГБУ «НМИЦ АГиП им. В.И. Кулакова» Минздрава России. Тел.: +7(916)089-08-09. E-mail: nika06@inbox.ru.117997, Россия, Москва, ул. Академика Опарина, д. 4.
Назаренко Татьяна Алексеевна, д.м.н., профессор, директор Института репродуктивной медицины, ФГБУ «НМИЦ АГиП им. В.И. Кулакова» Минздрава России.
Тел.: +7(985)998-74-12. E-mail: t_nazarenko@oparina4.ru. 117997, Россия, Москва, ул. Академика Опарина, д. 4.
Хохлова Светлана Викторовна, д.м.н., заведующая онкологическим отделением противоопухолевой лекарственной терапии, ФГБУ «НМИЦ АГиП им. В.И. Кулакова» Минздрава России. Тел.: +7(903)170-98-02. E-mail: s_hohlova@oparina4.ru.
117997, Россия, Москва, ул. Академика Опарина, д. 4.
Для цитирования: Дмитриева И.Е., Назаренко Т.А., Хохлова С.В. Защита яичников перед гонадотоксичной терапией – проблема онкологии и репродуктивной медицины.
Акушерство и гинекология. 2020; 11: 13-19
https://dx.doi.org/10.18565/aig.2020.11.13-19