Abstract
Annually in Russia about 30 000 cases of oncological diseases in young women are diagnosed. The diagnosis of reproductive problems associated with treatment is still little discussed, although the practical recommendations of many professional organizations, including the American Society of Clinical Oncology, underscore the need for mandatory oncologist review of options for maintaining the patient’s fertility. The article analyzes the medical organization when detected in a female patient of childbearing age cancer is to use therapies aimed at subsequent implementation by the patient of her reproductive rights. It is noted that such opportunities are limited to current law, giving the right to persons with cancer at the expense of budget funds to use the methods of assisted reproduction and cryoconservation technologies for maintaining reproductive potential in cancer patients. The article presents evidence of the urgency of introducing changes to the orders of the Ministry of Health of Russia that limit the use of methods of assisted reproductive technologies for cancer patients at the expense of the budget.
Highlights
In Russia about 30 000 cases of oncological diseases in young women are diagnosed
The diagnosis of reproductive problems associated with treatment is still little discussed, the practical recommendations of many professional organizations, including the American Society of Clinical Oncology, underscore the need for mandatory oncologist review of options for maintaining the patient’s fertility
It is noted that such opportunities are limited to current law, giving the right to persons with cancer at the expense of budget funds to use the methods of assisted reproduction and cryoconservation technologies for maintaining reproductive potential in cancer patients
Summary
In Russia about 30 000 cases of oncological diseases in young women are diagnosed. В связи с этим обновленные международные рекомендации, основанные на данных об отдаленных эффектах гонадотоксичности химио- или лучевой терапии, указывают на преимущество превентивного подхода, включающего консультацию пациента у репродуктолога перед началом лечения и совместный с онкологом выбор метода для отдаленного сохранения репродуктивного резерва (органосохраняющая операция с дальнейшим применением методик вспомогательных репродуктивных технологий (ВРТ) или криоконсервация эмбрионов, ооцитов, спермы) [8]. Стандартом лечения рака тела матки I стадии, принятым Международной федерацией акушеров и гинекологов, является простая или расширенная гистерэктомия, при инвазии опухоли на глубину >50 % толщины миометрия также требуется лучевая терапия [11].
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