Tumors of female reproductive systemTumors of female reproductive systemОпухоли женской репродуктивной системы1994-40981999-8627Publishing House ABV Press121510.17650/1994-4098-2024-20-1-131-138GYNECOLOGY. REVIEWSГИНЕКОЛОГИЯ. ОБЗОРНЫЕ СТАТЬИModern issues of oncofertility and oncoreproductionСовременные вопросы онкофертильности и онкорепродукцииPetrovI. A.ПетровИ. А.
Russian Federation

2 Moskovskiy Trakt, Tomsk 634050, Russia 

Россия, 634050 Томск, Московский тракт, 2 

ChurkinE. O.ЧуркинЕ. О.
Russian Federation

2 Moskovskiy Trakt, Tomsk 634050, Russia 

Россия, 634050 Томск, Московский тракт, 2 

ArkhipovaYa. I.АрхиповаЯ. И.
Russian Federation

2 Moskovskiy Trakt, Tomsk 634050, Russia 

Россия, 634050 Томск, Московский тракт, 2 

ChernyshovaA. L.ЧернышоваА. Л.
Russian Federation

5 Kooperativnyy Pereulok, Tomsk 634009, Russia

15 Rechkunovskaya St., Novosibirsk 630055, Russia 

Россия, 634009 Томск, Кооперативный переулок, 5

Россия, 630055 Новосибирск, ул. Речкуновская, 15

ChernyakovA. A.ЧерняковА. А.
Russian Federation

 Aleksandr Alekseevich Chernyakov  

5 Kooperativnyy Pereulok, Tomsk 634009, Russia

15 Rechkunovskaya St., Novosibirsk 630055, Russia 

Александр Алексеевич Черняков

Россия, 634009 Томск, Кооперативный переулок, 5

Россия, 630055 Новосибирск, ул. Речкуновская, 15

a.cherniackow@yandex.ruSevostyanovaN. V.СевостьяноваН. В.
Russian Federation

2 Moskovskiy Trakt, Tomsk 634050, Russia 

Россия, 634050 Томск, Московский тракт, 2 

Siberian State Medical University, Ministry of Health of RussiaФГБУ ВО «Сибирский государственный медицинский университет» Минздрава РоссииResearch Institute of Oncology, Tomsk National Research Medical Center of the Russian Academy of SciencesНаучно-исследовательский институт онкологии ФГБНУ «Томский национальный исследовательский медицинский центр РАН»E.N. Meshalkin National Medical Research Center, Ministry of Health of RussiaФГБУ «Национальный медицинский центр им. акад. Е.Н. Мешалкина» Минздрава России190520242011311380212202318052024https://ojrs.abvpress.ru/ojrs/article/view/1215

The problem of the occurrence of malignant neoplasms in women of reproductive age has not only medical, but also extremely important social significance, as it affects the demographic potential of the country as a whole.The article presents an analysis of the current state of the problem of fertility and preservation of reproductive function in cancer patients. Currently, there are a sufficient number of methods of assisted reproductive technologies aimed at preserving fertility in women with cancer. Among them are the following: cryopreservation of embryos and oocytes, ovarian tissue, in vitro maturation of eggs, obtaining oocytes obtained by removing the ovaries with their subsequent maturation. In addition, auxiliary methods are also distinguished, the main purpose of which is ovarian protection: the use of gonadotropin-releasing hormone agonists, ovarian transposition, gonadal screening. Each method has its advantages and disadvantages. It should be noted that the very fact of the presence of oncological pathology makes its own adjustments to the use of each specific technique. It has been shown that in vitro maturation technology is the most optimal for the preservation and realization of reproductive function in cancer patients. One of its few disadvantages is the high cost and complexity of laboratory control and cultivation of oocytes, which undoubtedly requires highly qualified specialists and relevant experience.

Проблема возникновения злокачественных новообразований у женщин репродуктивного возраста имеет не только медицинскую, но и крайне важную социальную значимость, так как влияет на демографический потенциал страны в целом.

В статье представлен анализ современного состояния проблемы фертильности и сохранения репродуктивной функции у онкологических больных. В настоящее время существует достаточное количество методов вспомогательных репродуктивных технологий, нацеленных на сохранение фертильности у женщин с онкологическими заболеваниями. Среди них выделяют криоконсервацию эмбрионов и ооцитов, овариальной ткани, созревание яйцеклеток in vitro, забор ооцитов из экстрагированной овариальной ткани с последующим их дозреванием in vitro. Кроме того, выделяют и вспомогательные методы, главной целью которых является овариальная протекция: использование агонистов гонадотропин-рилизинг-гормона, транспозицию яичников, экранирование гонад. У каждого метода есть свои достоинства и недостатки. Следует отметить, что сам факт наличия онкологической патологии вносит свои коррективы в использование каждой конкретной методики. Показано, что технология созревания яйцеклеток in vitro является наиболее оптимальной в отношении сохранения и реализации репродуктивной функции у онкологических больных. Одними из немногих ее недостатков являются высокая стоимость и сложность лабораторного контроля и культивирования ооцитов, что, несомненно, требует привлечения специалистов с высокой квалификацией и соответствующим опытом.

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