Ma Polani, ʻoi aku ka nui o 1,5 miliona mau kāne i hoʻāʻo ʻole e hāpai. Inā ma ka ʻaoʻao o ka wahine ke kumu o ka pilikia, ʻo ia paha ka hopena o nā maʻi ovulation, endometriosis, a me nā lapaʻau mua, e laʻa i nā maʻi oncological. ʻO ka poʻe maʻi i hana i kēia ʻano lapaʻau pinepine ʻaʻole lākou i ʻike no nā makahiki he nui ua nalowale ko lākou momona. A hiki i ka moeʻuhane i kahi pēpē.

  1. ʻO ka mālama ʻana i kekahi mau maʻi – ka nui o nā maʻi oncological – e hōʻino i ka momona o ka wahine, akā ʻo ka pono o ka mālama wikiwiki ʻana e lilo kēia pilikia i kumu lua.
  2. ʻO ka lālā ʻōpiopio o ka lāʻau lapaʻau - oncofertility, pili i ka hoʻihoʻi ʻana i ka momona i nalowale ma kēia ʻano
  3. ʻO kekahi o nā ʻano o ka oncofertility ʻo cryopreservation - ma hope o ka hoʻopau ʻana i ka mālama ʻana, ua hoʻokomo ʻia ka mea maʻi me kahi ʻāpana olakino i loaʻa mua i ka ovary, pono e hoʻomaka i ka hana. ʻAe kēia i kekahi manawa e hāpai maoli ʻoe. Mahalo i kēia, ua hānau ʻia nā keiki 160 i ka honua, ʻekolu ma Polani

ʻO ka hemahema o ka hānau ʻana ka hopena maʻamau o ka lāʻau lapaʻau. ʻO ia e pili ana i nā mea i kapa ʻia ʻo gonadotoxic therapies, i hoʻohana ʻia i nā maʻi oncological a me ka rheumatic, nā maʻi pili pili, a me ka hihia o fibroids a i ʻole endometriosis. ʻOi loa i ka wā e pili ana i nā maʻi neoplastic - ʻo ka manawa e hoʻomaka ai i nā mea lapaʻau. A laila noho hope ka fertility. ʻO ka ʻoiaʻiʻo, ke iho nei a hiki i kēia manawa, no ka mea i kēia lā ua nui nā ala e mālama ai. Me nā poʻe maʻi e hana nei i kēia ʻano o ka lāʻau i ka noʻonoʻo, ua hoʻokumu ʻia kahi ʻāpana o ka lāʻau lapaʻau - oncofertility. He aha ia? Ma nā kūlana hea e kōkua ai? Kūkākūkā mākou no ia mea me prof. ʻO Dr. hab. n. med. ʻO Robert Jachem, ke poʻo o ke Keʻena Clinical o Gynecological Endocrinology a me Gynecology ma ke Kulanui o ke Kulanui ma Krakow.

Justyna Wydra: He aha ka oncofertility?

Ua loaʻa iā Prof. Dr. n.med. Robert Jach: Oncofertility kahi kahua ma ka palena o ka gynecology, oncology, reproductive medicine and gynecological endocrinology. I ka pōkole, aia i ka mālama ʻana i ka momona a me ka hoʻihoʻi ʻana iā ia ma hope o ka pau ʻana o ka pōʻaiapuni oncological, a i ʻole nā ​​​​lāʻau ʻē aʻe e hoʻohana ana i nā lāʻau cytotoxic. Ua hoʻokumuʻia ka hua'ōlelo i ka makahiki 2005, akā ua hanaʻo ia ma keʻano he lāʻau lapaʻau mai ka makahiki 2010. Ua hoʻokomoʻia ka manaʻo i ka lāʻau lapaʻau e kahi mea noiʻiʻAmelika - prof. Teresa K. Woodruff mai ke Kulanui o Northwestern ma Chicago. Mai Ianuali o kēia makahiki, ma ʻAmelika Hui Pū ʻIa, e like me ke kūlana o ka American Society for Reproductive Medicine ASRM, ʻaʻole i manaʻo hou ʻia ka hoʻoheheʻe ʻana o ka ovarian tissue, kekahi o nā ʻano i hoʻohana ʻia i ka oncofertility. Ma ʻEulopa, me Polani, ke hoʻomaka nei ka hana ma kāna ʻike kūhelu.

He aha nā ʻano hana i hoʻohana ʻia ma kēia kahua?

I ka manawa mua, inā hiki, hoʻohana ʻia nā kaʻina hana hoʻokaʻawale o ke kino hānau. Ma kahi o ka wehe ʻana i ka ʻōpū a me nā ovaries, hana ʻia ke ʻokiʻoki no ka mālama ʻana i kēia mau ʻōpū. Eia nō naʻe, ʻo ke ʻano o ke kaʻina hana holoʻokoʻa i kōkua ʻia i nā ʻenehana reproductive e hōʻoiaʻiʻo i nā hana hānau i ka wā o ka mālama ʻana.

ʻO kēia mau ʻano hana: ka hoʻoheheʻe ʻana i ka hua manu no nā wahine, ka sperm no nā kāne, ke kaʻina hana in vitro (embryo freezing), a me ka maloʻo (cryopreservation) o kahi ʻāpana o ka ʻiʻo ovarian i hōʻiliʻili ʻia i ka laparoscopy, ʻoiai ma mua o ka hoʻokō ʻana i ka chemotherapy a i ʻole radiotherapy. Ma hope o ka pau ʻana o ia ʻano lapaʻau gonadotoxic, hoʻokomo ʻia ka mea maʻi me kahi ʻāpana olakino maikaʻi i wehe mua ʻia o ka ovary, a laila e lawe i kāna hana koʻikoʻi, ʻo ka endocrine a me ka germline. ʻO ka hopena, i kekahi manawa ke hopena i ka hiki ke hāpai maoli, me ka ʻole o ka pono e keakea i ke ʻano o nā kaʻina hana reproductive i kōkua ʻia, ʻaʻole i ʻae pinepine ʻia no nā kāne no nā kumu like ʻole.

He aha nā pōmaikaʻi o kēia ʻano?

ʻO ka mea mua, ʻoi aku ka pōkole o ke ʻano o ka cryopreservation o ka ʻiʻo ovarian i hōʻiliʻili i ka laparoscopically ma mua o ke kaʻina in vitro. Hiki ke hana i ka lā hoʻokahi. ʻO ka mea maʻi e aʻo ana, no ka laʻana, i loko o ʻelua pule e hoʻomaka ʻo ia i ka mālama ʻana i ka oncological, ma hope o ka hoʻokō ʻana i nā koina kūpono, pono ke kūpono no kahi kaʻina hana laparoscopic minimally invasive. He 45 mau minuke. I kēia manawa, hōʻiliʻili ʻia kahi ʻāpana o ka ovary (ma kahi o 1 cm).2) a me nā ʻenehana oncofertility, mālama ʻia kēia ʻāpana kiko. Hiki i ka mea maʻi ke hoʻi i ka home ma ia lā a i ʻole ka lā aʻe. Ma hope o ka convalescence pōkole, ua mākaukau ʻo ia no ka mālama nui, maʻamau oncological. ʻO kēia mau ʻano lapaʻau ke kumu pinepine i ka infertility. Ma hope o ko lākou hoʻopauʻana, hiki i ka wahine ke hoʻi i ke kikowaena, kahi i hoʻokomo muaʻia ai ka mea i hōʻiliʻili muaʻia a me ka hau hau i loko o ka ovary e ka laparoscopy. ʻO ka mea maʻamau, hoʻopau ke kino i kāna hana nalowale. Ma muli o nā kaʻina hana oncofertility, hiki i ka mea maʻi ke hāpai maoli. Hoʻihoʻi ʻia nā ovaries i kā lākou hana germinal no kahi o ʻelua makahiki. I kekahi mau hihia, hoʻonui nui ʻia kēia manawa.

No ke aha e lilo ai ka mea maʻi i ka momona ma hope o ka radiotherapy a i ʻole ka chemotherapy?

No ka wehewehe ʻana i kēia ʻano hana, pono ʻoe e ʻike pehea e ulu ai ke kanesa. He mahele wikiwiki ʻole ia o nā pūnaewele e nā pale kūlohelohe o ke kino. Hoʻomāhuahua ʻole nā ​​​​pūnaewele, e hana ana i kahi maʻi koko e hoʻokomo i nā ʻiʻo pili, a me ka hopena i ke kūkulu ʻana i nā metastases lymphatic a me nā moku koko. Ma ka ʻōlelo maʻamau, hiki ke wehewehe ʻia ke kanesa ma ke ʻano he parasite nāna e hoʻopau i kāna mea hoʻokipa. I ka huli ʻana, hoʻolālā ʻia ka chemotherapy a i ʻole radiotherapy, ʻo ia hoʻi ka mālama ʻana i ka gonadotoxic, e luku i kēia mau puʻupuʻu puʻupuʻu wikiwiki. Ma waho aʻe o ka hoʻopaʻa ʻana i nā pūnaewele maʻi maʻi, hoʻōki ia i nā ʻāpana ʻē aʻe e hoʻokaʻawale wikiwiki i ke kino mai ka māhele ʻana. Aia kēia pūʻulu i nā follicles lauoho (no laila ke ʻano o ka hemo ʻana o ka lauoho o ka chemotherapy), nā pūnaewele iwi iwi (hiki ke hoʻoulu i ka anemia a me ka leukopenia) a me ka ʻāpana digestive (kahi e hoʻoulu ai i ka nausea a me ka luaʻi), a ʻo ka hope, nā cell reproductive - e alakaʻi i ka infertility.

  1. ʻO ka holomua o nā kauka Farani. ʻO ka mea maʻi i nalowale i kona momona ma hope o ka chemotherapy i loaʻa i kahi pēpē mahalo i ke ʻano IVM

ʻEhia mau pēpē i hānau ʻia i kēia manawa ma muli o ke ʻano cryopreservation a mākou i kamaʻilio mua ai?

Ma kahi o 160 mau keiki i hānau ʻia ma ka honua, mahalo i ke ʻano o ka cryopreservation a me ka hoʻokomo hou ʻana o ka ʻiʻo ovarian olakino i loko o ke kino o nā maʻi ma hope o ka gonadotoxic therapy. Ke noʻonoʻo nei i ka ʻoiaʻiʻo ma ko mākou ʻāina ua manaʻo ʻia ke kaʻina hana he hoʻokolohua a ʻaʻole i uku hou ʻia e ka National Health Fund, ʻike mākou i kēia manawa e pili ana i ʻekolu mau keiki i hānau ʻia ma kēia ala ma Polani. ʻElua o lākou i hānau i nā maʻi ma ke kikowaena kahi aʻu e hana ai.

He mea kūpono hoʻi e haʻi ʻia aia ma kahi o ka nui o nā ʻiʻo ovarian i hōʻiliʻili ʻia a maloʻo mai nā maʻi i hoʻoholo ʻole e hana i kēia kaʻina hana. Ke hoʻomau nei kekahi o lākou i ka mālama ʻana i ka oncological, a ʻo ke koena ʻaʻole i hoʻoholo e hānau hou.

Ua ʻike ʻia nā poʻe maʻi e hele ana i nā lāʻau lapaʻau gonadotoxic e pili ana i nā hiki o nā ʻano oncofertility? Ua ʻike nā kauka i kēia ʻenehana?

ʻO ka mea pōʻino, ʻaʻohe o mākou ʻikepili e pili ana i ka ʻike o nā kauka, akā ma ke ʻano he ʻāpana o ka hana a ka hui hana i ka mālama ʻana i ka momona i nā maʻi maʻi oncological o ka Polish Society of Oncological Gynecology, ua hana mākou i kā mākou noiʻi nīnau nīnau. Hōʻike lākou i loko o ka pūʻulu hoʻomaopopo ākea o nā oncologists, gynecologists, oncologists, clinical oncologists a me radiotherapists, aia ka ʻike o kēia pilikia (ma luna o 50% o nā mea pane i lohe e pili ana i ke ʻano), akā ma lalo o 20%. Ua kūkākūkā nā kauka i kēia me kahi maʻi.

Ke hoʻi mai nei i ka hapa mua o ka nīnau, ua ʻike piha nā lālā o nā hui maʻi like ʻole i ka pilikia a me nā pilikia e hiki mai ana, a me nā hoʻonā hiki. Eia naʻe, ʻaʻole kēia he hui ʻelele. ʻO ka mea pōʻino, ʻaʻohe ʻike nui o nā wahine i pili ʻole i kēia ʻano hui. ʻO ia ke kumu e alakaʻi ai mākou i nā ʻano hoʻomaʻamaʻa like ʻole i nā manawa āpau, a ʻike ʻia ke kumuhana i ka wā o nā hālāwai kūkā a me nā webinars. Mahalo i kēia, ke ulu mau nei ka ʻike o nā maʻi ma kēia kumuhana, akā i koʻu manaʻo ke hele mālie nei.

ʻIke e pili ana i ka loea:

Prof. dr hab. n.med. He loea ʻo Robert Jach i ka obstetrics and gynecology, loea i ka gynecological oncology, loea i ka endocrinology gynecological a me ka lāʻau lapaʻau hānau. Peresidena o ka Polish Society of Cervical Colposcopy and Pathophysiology, ka mea aʻoaʻo kūloko ma ke kahua o ka endocrinology gynecological a me ka hana hou. ʻO ia ke poʻo o ka Clinical Department of Gynecological Endocrinology and Gynecology ma ke Kulanui o ke Kulanui ma Krakow. Hoʻomaʻamaʻa pū ʻo ia ma ka Superior Medical Center ma Krakow.

E heluhelu pū hoʻi:

  1. ʻO ke kaumaha postpartum ma hope o IVF. He pilikia i kamaʻilio ʻole ʻia
  2. ʻO nā moʻolelo maʻamau e pili ana i ka IVF
  3. He umi hewa i ka fertility

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