Nove Europske smjernice protokola stimulacije ovulacije za očuvanje plodnosti pacijentica s onkološkim bolestima

master's thesis

• Title (english): Ovarian stimulation protocols for fertility preservation in oncologic patients - new European guidelines
• Author: Mia Petravić
• Mentor: Dinka Pavičić Baldani (mentor)
• Committee member: Lana Škrgatić (predsjednik povjerenstva)
• Committee member: Željko Duić (član povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

U novije vrijeme bilježi se stalan porast neplodnosti u žena. Jedan od razloga stoji u povećanoj incidenciji zloćudnih novotvorina u reproduktivnoj dobi. Agresivno liječenje koji se primjenjuju u terapiji zloćudnih novotvorina često rezultira oštećenom reproduktivnom funkcijom. U 40% do 68% slučajeva dolazi do oštećenja funkcije jajnika, odnosno prijevremene ovarijske insuficijencije i posljedične amenoreje i neplodnosti. Stoga je važno definirati jasne smjernice očuvanja plodnost u žena koje još nisu ostvarile svoje potomstvo, kako bi se nakon izlječenja primarne bolesti mogle ostvariti reprodukciju. U ovom preglednom radu prikazan je utjecaj gonadotoksičnih lijekova, koji se primjenjuju u terapiji zloćudnih novotvorina, na reproduktivnu sposobnost i funkciju jajnika. Prikazane su mjere zaštite jajnika tijekom kemoterapije i radioterapije pomoću GnRH agonista, te metoda transpozicije jajnika izvan polja zračenja prije početka radioterapije. Najveći naglasak stavljen je na nove Europske smjernice odnosno protokole stimulacije ovulacije. Opisane su tehnike očuvanja plodnosti koje se danas smatraju standardom liječenja, krioprezervacija oocite, embrija, te tkiva jajnika.

Abstract (english)

We are facing a continuous increase in infertility in women, and one of the reasons is the increased incidence of malignant neoplasms in the reproductive age. Aggressive treatments used in the treatment of malignant neoplasms often result in impaired reproductive function. In 40% to 68% of treated cases the ovarian damage and premature ovarian failure with the consequent amenorrhea and infertility can occur. Therefore, it is important to define clear guidelines for preserving fertility in women who have not finished their reproductive function, so that after recovery from their primary disease, they can dedicate themselves to family planning. This review paper presents the influence of gonadotoxic treatments, which are applied in the treatment of malignant neoplasms, on the reproductive ability and ovarian function. The importance of ovarian protection measures during chemotherapy and radiotherapy using GnRH agonists has been shown, and ovarian transposition methods as well. The focus on the new European guidelines for ovulation stimulation, and their protocols was given. The fertility preservation techniques that are considered standard today, cryopreservation of oocytes, embryos, and ovarian tissue were described.

• Keywords: očuvanje plodnosti; stimulacija ovulacije; zloćudne novotvorine; gonadotoksičnost
• Keywords (english): fertility preservation; ovarian stimulation; malignant neoplasm; gonadotoxicity
• Language: croatian
• URN:NBN: urn:nbn:hr:105:053753
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-03-25 13:18:34