{"id":198,"title":"Fertility preservation for patients undergoing pelvic malignancy treatment: Current strategies, emerging approaches, and clinical considerations","title_zh":"盆腔恶性肿瘤治疗患者的生育力保存：现有策略、新兴方法与临床考量","url":"https://pubmed.ncbi.nlm.nih.gov/42969178","doi":"10.1002/ijgo.71468","pmid":"42969178","journal":"Int J Gynaecol Obstet","kind":"paper","lang":"en","published_at":"2026-11-02T00:00:00+00:00","fetched_at":"2026-11-08T03:43:57+00:00","authors":["Apelian S","Mathyk B","Agarwal N","Yasukawa M","Kohut A","Markel L","Liu C","Anderson ML","Rutherford T","Andikyan V"],"primary_topic":"fertility-preservation","topics":[{"slug":"fertility-preservation","score":8.0,"hits":["fertility preservation","gonadotoxic","oncofertility","ovarian tissue","ovarian tissue cryopreservation"]},{"slug":"oocyte","score":3.0,"hits":["oocyte","ovarian","ovarian reserve"]},{"slug":"endometrium","score":2.0,"hits":["uterine","uterus"]},{"slug":"art-clinical","score":1.0,"hits":["infertility"]},{"slug":"embryology-lab","score":1.0,"hits":["cryopreservation"]},{"slug":"repro-tox","score":1.0,"hits":["gonadotoxic"]}],"topic_score":8.0,"preference_score":0.0,"preference_labels":[],"llm_score":78.0,"final_score":78.0,"score_dims":{"novelty":62,"rigor":70,"impact":80,"relevance":92,"translation":85},"recommend_reason":"系统梳理盆腔恶性肿瘤治疗中生育力保存的现有与新兴策略，对肿瘤生殖学临床决策和多学科协作有较高参考价值；作为综述，新颖性和原始证据强度有限。","keywords":["生育力保存","盆腔恶性肿瘤","卵巢组织冻存","卵巢移位","子宫移植","肿瘤生殖学"],"selected":1,"story_id":195,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-gametes","source_name":"PubMed · 配子与性腺","source_tier":1,"mention_count":2,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"该综述总结盆腔恶性肿瘤患者接受放疗、化疗及多模式治疗时的生育力保存策略。文章指出，生殖风险与可选方案取决于年龄、青春期状态、肿瘤类型、治疗紧迫性、放疗野、化疗方案与剂量、基线卵巢储备及生育意愿。已确立方法包括胚胎、卵母细胞和卵巢组织冻存；手术方法包括卵巢移位、子宫腹壁固定和子宫移位，可减少生殖器官放疗暴露；子宫移植为特定不可逆子宫性不孕患者提供恢复性选择，但高度专业化且资源密集。作者强调应早期讨论并纳入多学科肿瘤照护，仍需更多研究明确生殖结局、妊娠安全性及新兴方法比较效果。","summary":"Advances in cancer treatment have improved survival rates for many patients with pelvic malignancies, highlighting the importance of long-term reproductive outcomes and overall quality of life. Pelvic radiotherapy, chemotherapy, and multimodal treatment can cause substantial and permanent injury to ovarian reserve, uterine function, or both. Oncofertility can be clinically complex because reproductive risks and available options vary according to patient age, pubertal status, cancer type, treatment urgency, planned radiotherapy field, chemotherapy regimen and dosage, baseline ovarian reserve, desire for future pregnancy, and expertise. The present review summarizes established and emerging fertility preservation options for patients undergoing treatment for pelvic malignancies. Cryopreservation focused options, including embryo, oocyte, and ovarian tissue cryopreservation, can preserve gametes, embryos, or ovarian tissue before gonadotoxic therapy but do not protect the uterus from radiation related injury. Surgical approaches, including ovarian transposition, uterine ventrofixation, and uterine transposition, are aimed at reducing radiation exposure to reproductive organs, although their effectiveness depends on surgical technique, radiation planning, and use of systemic therapy. Uterine transplantation may provide a restorative option for selected patients with irreversible uterine factor infertility but remains highly specialized and resource intensive. Because each option differs in timing, evidence base, risks, costs, resource requirements, and applicability across patient groups, fertility preservation should be discussed early and incorporated into multidisciplinary cancer care. Continued research is needed to better define reproductive outcomes, pregnancy safety, complications, and comparative effectiveness of emerging approaches.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}