Tumors of female reproductive systemTumors of female reproductive systemОпухоли женской репродуктивной системы1994-40981999-8627Publishing House ABV Press117110.17650/1994-4098-2023-19-4-123-131GYNECOLOGY. REVIEWSГИНЕКОЛОГИЯ. ОБЗОРНЫЕ СТАТЬИMethods for preserving fertility in childhood cancer patientsМетоды сохранения фертильности у онкологических больных в детском возрастеhttps://orcid.org/0000-0002-3253-4512AdamyanL. V.АдамянЛ. В.
Russian Federation

4 Akademika Oparina St., Moscow 117997;

28 Orekhovyy Bulvar, Moscow 115682

117997 Москва, ул. Академика Опарина, 4;

127473 Москва, ул. Делегатская, 20/1

https://orcid.org/0000-0002-4540-6341SibirskayaE. V.СибирскаяЕ. В.
Russian Federation

28 Orekhovyy Bulvar, Moscow 115682;

1 Ostrovityanovа St., Moscow 117997

127473 Москва, ул. Делегатская, 20/1;

117997 Москва, ул. Островитянова, 1

https://orcid.org/0000-0002-6844-3321PivazyanL. G.ПивазянЛ. Г.
Russian Federation

4 Akademika Oparina St., Moscow 117997

117997 Москва, ул. Академика Опарина, 4

https://orcid.org/0000-0002-1316-6291ObosyanL. B.ОбосянЛ. Б.
Russian Federation

Liliya Borisovna Obosyan

Build. 1, 2 Bolshaya Pirogovskaya St., Moscow 119435

Лилия Борисовна Обосян

119991, Москва, ул. Трубецкая, 8, стр. 2

borisovna77510@gmail.comhttps://orcid.org/0000-0002-6004-4369AnanyevaV. S.АнаньеваВ. С.
Russian Federation

Build. 1, 2 Bolshaya Pirogovskaya St., Moscow 119435

119991, Москва, ул. Трубецкая, 8, стр. 2

https://orcid.org/0000-0002-5593-6549LaevskayaA. A.ЛаевскаяА. А.
Russian Federation

Build. 1, 2 Bolshaya Pirogovskaya St., Moscow 119435

119991, Москва, ул. Трубецкая, 8, стр. 2

V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of RussiaФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. акад. В.И. Кулакова» Минздрава РоссииFederal Research Clinical Center for Specialized Types of Health Care and Medical Technologies of Federal Medical and Biology Agency of the RussiaФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Минздрава РоссииN.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииI.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)2012202319412313120012024200120242023https://ojrs.abvpress.ru/ojrs/article/view/1171

Each year, more than 400,000 children and adolescents under the age of 18 are diagnosed with cancer. The most common nosologies in childhood are leukemia, lymphoma and brain tumors. The use of chemoradiotherapy as an antitumor treatment in these cases is associated with a high risk of gonadotoxicity. The preservation of fertility in children and adolescents during malignant tumor therapy is one of the key aspects of treatment. To date, there are many unresolved issues in this problem, affecting the preservation of both physical and psychological health of patients in adulthood. The main methods of maintaining the reproductive function in girls are cryopreservation of ovarian tissue or oocytes, ovarian autotransplantation, the use of assisted reproductive technologies, including the techniques of in vitro fertilization and in vitro oocyte maturation, oophoropexy and neoadjuvant cytoprotective pharmacotherapy. The choice of fertility preservation method depends on many factors: the overall condition of the child, the type of malignant disease, the age and sexual status of the patient, the capabilities of the medical center, as well as legal and financial aspects. Due to the lack of information on pediatric oncofertility, large-scale multicenter clinical trials involving children and adolescents are needed.

Ежегодно у более 400 тыс. детей и подростков в возрасте до 18 лет диагностируются онкологические заболевания. Наиболее распространенными нозологиями в детском возрасте являются лейкозы, лимфомы и опухоли головного мозга. Применение химиолучевой терапии в качестве противоопухолевого лечения в данных случаях сопряжено с высоким риском гонадотоскичности. Сохранение фертильности у детей и подростков при терапии злокачественных новообразований является одним из ключевых аспектов лечения. В настоящее время в данной проблеме остается множество нерешенных вопросов, влияющих на сохранение как физического, так и психологического здоровья пациентов во взрослом возрасте. Основными методами поддержания репродуктивной функции у девочек являются криоконсервация ткани яичника или ооцитов, аутотрансплантация яичника, применение вспомогательных репродуктивных технологий, в том числе методик экстракорпорального оплодотворения и созревания ооцитов in vitro, оофоропексия и неоадъювантная цитопротекторная фармакотерапия. Выбор метода сохранения фертильности зависит от множества факторов: общего состояния ребенка, типа злокачественного заболевания, возраста и полового статуса пациента, возможностей медицинского учреждения, а также юридических и финансовых аспектов. Вследствие недостатка информации по вопросам онкофертильности в детском возрасте необходимо проведение масштабных многоцентровых клинических исследований с участием детей и подростков.

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