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Features of carrying out of PLAITS in programs of conservation of a fecundity at patients c oncologic diseases of genesial age

One of methods of conservation of a genetic material at women with oncologic diseases is kriokonservatsija oocytes.

For the purpose of conservation of genesial function to oncologic patients in world clinics VRT, even more often apply strategy kriokonservatsii cells and tissues.

Most activly in this area work: Kato Ladies clinic (Japan) and McGill Reproductive Center (Canada). The first bank of oocytes «Future Mother» has been framed in 2001 in Japan. In 2006 the American society of clinical oncology (ASCO) has confirmed clinical references about conservation of a fecundity at oncologic patients with application of methods VRT.

Fence of a genetic material at oncologic patients make prior to the beginning chemio - and radial therapy [12,84,170,171], and the impossibility of a delay in carrying out of therapy of a basic disease demands the beginning of stimulation since any day of a menstrual cycle. It is important to notice, that for the purpose of fecundity conservation, application supervised ovarialnoj stimulations assotsiirovano with short on time, but essential rising in blood of level of Oestradiolum. This circumstance brings an attention to the question on safety of application supervised ovarialnoj stimulations at patients with oncologic diseases at which on tumoral cells there can be receptors to estrogens, that, first of all, concerns a mammary gland cancer. Thus, the important making part of reports of PLAITS of oncologic patients is application of inhibitors of an aromatase, first of all, letrozola. This preparation at appointment in a dose of 2,5-5 mg/day is an effective inductor of plural growth of follicles, especially in a combination to small doses exogenous FSG [141]. It is shown, that use at patients with a cancer of a mammary gland of PLAITS with application letrozola (5 mg) in a combination to daily injections of preparations FSG, has allowed to receive on the average 8,5 yo 1,6 oocytes and 5,3 yo 0,8 embryoses, the given indicators above, than at sochetannom Tamoxifenum application (60 mg a day) and same doses FSG (5,1 yo 1,1 oocytes and 3,8 yo 0,8 embryoses) or applications only Tamoxifenum (1,5 yo 0,3 and 1,3 yo 0,2, accordingly). Moreover, ovarialnaja stimulation with application letrozola was accompanied by much lower levels of Oestradiolum, that also can testify to relative safety of the given scheme [186]. Replacement HGCH by a preparation a-gnrg can be other approach for depression of level of Oestradiolum. Oestradiolum level in blood in this case quickly decreases to level of basal indicators [126].

Now schemes ovarialnoj stimulations which can be begun not only with the beginning of a menstrual cycle of the woman, from the middle follikulinovoj phases, but also with ljuteinovoj phases of a cycle [256,257] are developed. Considering that the purpose supervised ovarialnoj stimulations in this case is reception of oocytes without necessity of parallel growth endometrija, it facilitates carrying out of PLAITS in ljuteinovuju a cycle phase. It is shown, that results ovarialnoj stimulations at patients with oncologic diseases in need of its beginning in follicular and ljuteinovuju cycle phases are comparable [244].

The extremely important is the question on safety of the applied report supervised ovarialnoj stimulations in respect of the forecast of oncologic disease. It is shown, that the four-year-old survival rate of patients with a mammary gland cancer at application of PLAITS for conservation of genesial function did not differ in comparison with patients at whom stimulation was not spent [184]. Results of research in which 143 patients with a mammary gland cancer received ovarialnuju stimulation letrozolom 5 mg in a combination to application as the trigger of an ovulation of chorionic Gonadotropinum (89 patients) or a-gnrg (54 patients) have been presented. At 31 patients after achievement of proof remission it has been decided to use embryoses for the genesial purposes. Carrying over of the defrozen embryoses to 13 cases has been carried out to patients and in 18 cases to substitute mothers. Frequency of offensive of pregnancy and sorts has made in group of patients of 77 % and 54 %, and in group of substitute mothers of 67 % and 28 %, accordingly [186].

It is necessary to notice, that a problem of a choice of the ideal report of PLAITS, according to the literature, at oncologic patients it is not solved because of absence scale randomizirovannyh the researches, allowing to do statistically substantiated conclusions [12].

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A source: GABARAEVA Victoria VLADISLAVOVNA. the DIFFERENTIATED approach to a choice of the report SUPERVISED OVARIALNOJ STIMULATIONS At DONORS of OOCYTES And PATIENTS With ONCOLOGIC DISEASES. The dissertation on competition of a scientific degree of the candidate of medical sciences. St.-Petersburg - 2016. 2016

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  7. DOLZHENKO IRINA SERGEEVNA. GENESIAL HEALTH of GIRLS TILL 18 YEARS (a condition, an estimation, system of measures on its conservation) the Dissertation on competition of a scientific degree of the doctor of medical sciences. Moscow -, 2004 2004
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