促性腺激素释放激素激动剂在化疗患者卵巢功能保护的应用研究进展

Current progress of application of GnRH agonists for preservation of ovarian function in patients receiving chemotherapy

化疗在改善患者疾病预后的同时也可通过多种分子反应损害卵巢功能,严重影响生育力。现临床常推荐在化疗前实施胚胎和卵母细胞冷冻,从而保存生育力,但并不适用于所有人群,且不能预防化疗引起的卵巢损害。促性腺激素释放激素激动剂(GnRH-a)通过降调节作用可减轻化疗引起的性腺毒性,对生育力有保护作用,但其有效性尚未达成共识,作用机制也暂不明确。本文概述了化疗引起卵巢损伤的机制、GnRH-a在化疗患者卵巢功能保护的应用及保护机制、评价指标和安全性等,为探究GnRH-a有效性及进一步明确其临床适用范围、作用机制及安全性,适时正确合理用药提供参考。

While chemotherapy improves the prognosis of patients with cancer,it may impair ovarian function through multiple mechanisms,which can lead to female infertility.Embryo and oocyte cryopreservation for fertility preservation before chemotherapy is recommended.The method is not suitable for all populations and does not prevent chemotherapy-induced ovarian damage.GnRH agonist(GnRH-a)can alleviate chemotherapy induced gonadal toxicity through its down-regulation effect and have a protective effect on fertility.However,its effectiveness needs to be further clarified,and the mechanism of the protection remains largely unclear.This review outlines the mechanism of ovarian damage caused by chemotherapy and the use of GnRH-a to protect ovarian function in patients receiving chemotherapy.The mechanism of protection,evaluation indexes and its safety are discussed.The review provides reference for further clarifying its clinical scope of application,underlying mechanism and medication safety.