RESUMO
La sobrevida de pacientes con cáncer ha mejorado con el tiempo, especialmente en pacientes en edad fértil. La criopreservación de los ovocitos a través de la estimulación ovárica controlada (EOC) es la técnica más frecuente de preservación de la fertilidad. El objetivo del presente estudio es realizar un análisis descriptivo de los ciclos de pacientes que, previo al tratamiento de cáncer, realizaron un tratamiento de preservación de fertilidad. Se analizaron datos demográficos como edad, diagnóstico de ingreso y resultados clínicos, tales como tipo de protocolo de estimulación utilizado, número de ovocitos obtenidos, duración de la estimulación y momento de inicio en el ciclo. Resultados: La edad promedio fue 28.9 años. La duración media de la estimulación fue de 12 días, con un promedio de ovocitos obtenidos en total de 12. Se utilizaron 2 protocolos de estimulación ovárica, obteniendo mejores resultados con el esquema de antagonistas de GnRH asociado a letrozole y doble gatillante. Respecto al momento del ciclo en que se inició la estimulación ovárica, no hubo diferencias. Conclusiones: Es posible realizar preservación de la fertilidad previo a un tratamiento oncológico con buenos resultados en pacientes jóvenes, por lo que sugerimos realizarlo en todos los pacientes con diagnóstico oncológico antes el tratamiento del cáncer. Es recomendable comenzar la estimulación ovárica en cualquier fase del ciclo ya que se obtienen los mismos resultados y permite un pronto inicio de la terapia oncológica.
Survival of patients with cancer has been improving over time, especially in young patient with fertility intention. Cryopreservation of oocytes through controlled ovarian stimulation (EOC) is the most frequent technique of fertility preservation. We analyzed the data obtained from oncological patients who attended IVI Chile between January 2008 and May 2017 in search of fertility preservation. Demographic data were obtained: age, diagnosis of admission, type of stimulation protocol used, number of oocytes obtained, duration of stimulation and pregnancy rate. Results: The average age: 28,9 years; average duration of stimulation:12 days. Number of oocytes obtained in total: 12. Two ovarian stimulation protocols were used. The one with the best results was the protocol with GnRH antagonists associated with letrozole and double triggering. Regarding the moment of the cycle where to start ovarian stimulation, there were no differences. Conclusions: It is possible to carry out a fertility preservation treatment prior to an oncological treatment with good results in young patients, so we suggest the preservation of fertility in all patients with an oncological diagnosis before oncological treatment. It is recommended to start ovarian stimulation at any phase of the cycle since the same results are obtained.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Adulto Jovem , Oócitos/fisiologia , Indução da Ovulação/métodos , Vitrificação , Preservação da Fertilidade/métodos , Neoplasias , Criopreservação/métodos , Medicina ReprodutivaRESUMO
Asian-origin avian influenza (AI) viruses are spread in part by migratory birds. In Alaska, diverse avian hosts from Asia and the Americas overlap in a region of intercontinental avifaunal mixing. This region is hypothesized to be a zone of Asia-to-America virus transfer because birds there can mingle in waters contaminated by wild-bird-origin AI viruses. Our 7 years of AI virus surveillance among waterfowl and shorebirds in this region (1998-2004; 8,254 samples) showed remarkably low infection rates (0.06%). Our findings suggest an Arctic effect on viral ecology, caused perhaps by low ecosystem productivity and low host densities relative to available water. Combined with a synthesis of avian diversity and abundance, intercontinental host movements, and genetic analyses, our results suggest that the risk and probably the frequency of intercontinental virus transfer in this region are relatively low.