Review
作者: Sun, Yang ; Wang, Jianliu ; Wang, Daqing ; Wang, Yue ; Xue, Song ; Chen, Lei ; Ding, Yan ; Jin, Fengyu ; Lin, Yuan ; Song, Yali ; Wu, Ruifang ; Cheng, Jiaojiao ; Li, Bin ; Li, Peiling ; Xu, Che ; Sun, Yuan ; Yang, Jun ; Wu, Yurui ; Qin, Maoquan ; Zhang, Shulan ; Ruan, Xiangyan ; Liu, Rong ; Dai, Yinmei ; Wang, Gang ; Ni, Xin ; Mi, Xin ; Du, Juan ; Yang, Xin ; Cao, Xingyu ; Sun, Yange ; Wang, Jinping ; Huang, Hefeng ; Zhang, Hongqing ; Mueck, Alfred O ; Hu, Zhuoying ; Zhai, Jun ; Ren, Mulan ; Xiong, Xiumei ; Jin, Jing ; Jia, Haiwei ; Tian, Qinjie ; Chen, Jiao ; Zhang, Jing ; Jia, Zanhui ; Ju, Rui ; Gu, Yanfang ; Li, Zhihui ; Xu, Tianmin ; Luo, Suiyu ; Cao, Yunxia ; Zhang, Yun ; Xu, Binghe ; Peng, Xinkan ; Li, Fang ; Gu, Muqing ; Yin, Chenghong ; Jiao, Ruili ; Zhou, Qin ; Wang, Huali ; Xu, Liangzhi ; Ma, Fei ; Zhang, Wei ; Shi, Yuhua ; Kong, Weimin ; Wang, Shixuan ; Li, Xia
It is well known that premature ovarian insufficiency (POI) seriously affects the fertility, quality of life, and health of young women. A meta-analysis of global data indicated that the current population prevalence of POI is as high as 3.7 %, but exceeds 10 % in some countries and regions. When POI is caused by disease treatment, it is termed iatrogenic POI. Iatrogenic factors are the most common identifiable cause of POI, and iatrogenic POI has a high prevalence in young cancer survivors. Overall, iatrogenic POI accounts for approximately half of all cases, but data show that its prevalence in female cancer survivors under the age of 24 can reach up to 82.2 %. With the improvement of cancer treatment, this incidence is still rising. It arises in the context of a variety of diseases and has a complex etiology. Patients with iatrogenic POI tend to be younger than those with other types of POI, which means they can experience more harm from the condition, and there is an urgent need to diagnose, treat, and manage them as early as possible. However, there is currently no relevant consensus or guideline either within China or indeed internationally. This guideline expert group gathered data from doctors and patients in 34 provinces, municipalities, and autonomous regions across China through questionnaires to determine guideline-related issues and searched the literature in English-language databases such as Cochrane and PubMed since their establishment. After merging and deduplicating, literature evaluation and evidence grading were carried out. After discussion and induction, the clinical treatment and management guidelines for iatrogenic POI were formulated and combined with China's national conditions. The expert group ultimately addressed 19 clinical questions, as determined through a questionnaire survey and field investigation, and produced 26 recommendations based on international and domestic evidence from evidence-based medicine and clinical practice experience, to provide a reference for colleagues in clinical practice. The recommendations primarily reflect the context and needs within China and are intended for broad nationwide applicability, though regional adaptations based on local resources and practices may be necessary.