Preservação da fertilidade em pacientes oncológicos: métodos e aplicações

Abstract

Cancer is a mutagenic disease that requires treatments based on alkylating agents or ionizing radiation to inhibit the uncontrolled proliferation of malignancy, also affecting healthy body tissues. The incidence of these therapies in the gonadal tissues may imply in infertility. From this perspective, it was aimed to review the literature for a survey of the most used techniques for preserving fertility in cancer patients and the benefits applied to the clinical condition of each patient. Two databases were used, PubMed and Web of Science, selecting clinical studies through two search strategies: “Fertility preservation” OR oncofertility AND “ovar*” for female patients, and "Fertility preservation" OR "oncofertility" OR "cancer" AND "sperm*" OR "testicle" for male patients, resulting in 9 and 6 selected results, respectively. The results pointed to oocyte cryopreservation as the most cited technique for female patients, with breast cancer being the one with the highest incidence in the studies; and semen cryopreservation as the most cited technique for male patients, with testicular cancer having the highest incidence in the evaluated patients. It is also highlighted the importance of hormonal stimulation previously to the capture of oocytes, despite also drawing attention to possible adverse effects on patients with hormone-dependent cancers. Finally, the importance of associating assisted reproduction techniques with the preservation of fertility and well-being of cancer patients was concluded, aiming to reduce the impacts suffered by gonadotoxic treatment and provide positive future perspectives to patients. It is also important to highlight the difficulty in following up the patients for a long time, which may explain the occurrence of different outcomes in the face of the application of different techniques, when trying to track their success rates in obtaining a pregnancy at the end of the oncological treatment. It is evident, therefore, the importance of associating assisted reproduction techniques with fertility preservation, aiming to reduce the impacts suffered by the cancer patient during a potentially gonadotoxic treatment and to provide well-being and positive future perspectives to these patients, regarding the desire to constitute a family from their own gametes.