İnfertilite ve Kanser İlişkisi
Özet
Kanser ve infertilite arasındaki ilişkiyi inceleyen bu çalışma, onkolojik tedavilerin üreme sağlığı üzerindeki etkilerini ve fertiliteyi koruma stratejilerini ele almaktadır. Kanser tedavilerindeki ilerlemeler sağkalım oranlarını artırmış olsa da cerrahi, kemoterapi ve radyoterapi gibi yöntemler üreme gonadlarına zarar vererek geçici veya kalıcı kısırlığa yol açabilmektedir. Erkeklerde kısırlık ile testis kanseri arasında güçlü genetik, hormonal ve epidemiyolojik bağlar bulunurken, prostat kanseriyle olan ilişki çelişkilidir. Kadınlarda ise serviks, over ve endometrium kanserleri sonrası fertilite potansiyeli; hastanın yaşına, evresine ve uygulanan tedavi dozuna bağlı olarak değişir. Kanser tedavisi öncesinde erkekler için sperm ve testis dokusu kriyoprezervasyonu; kadınlar için ise oosit/embriyo dondurma, over transpozisyonu ve GnRH agonistleri ile over baskılanması gibi fertilite koruyucu stratejiler mevcuttur. Ayrıca, pelvik sinir ve damarların zarar görmesi nedeniyle kanser hastalarının en az yarısında uzun vadeli cinsel işlev bozuklukları gelişmekte ve bu durum çok disiplinli bir yaklaşım gerektirmektedir.
This study examining the relationship between cancer and infertility addresses the impacts of oncological treatments on reproductive health and fertility preservation strategies. Although advancements in cancer therapies have increased survival rates, methods such as surgery, chemotherapy, and radiotherapy damage reproductive gonads, leading to temporary or permanent infertility. In men, strong genetic, hormonal, and epidemiological links exist between infertility and testicular cancer, whereas the correlation with prostate cancer remains contradictory. In women, fertility potential after cervical, ovarian, and endometrial cancers varies depending on the patient's age, disease stage, and treatment dosage. Prior to cancer treatment, fertility preservation strategies are available, including sperm and testicular tissue cryopreservation for men, and oocyte/embryo freezing, ovarian transposition, and ovarian suppression via GnRH agonists for women. Furthermore, due to damage to pelvic nerves and blood vessels, long-term sexual dysfunction develops in at least half of cancer survivors, necessitating a multidisciplinary approach for management.
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