Fertility Preservation Strategies in Gynecologic Cancers

Abstract

The incidence of most gynecologic malignancies significantly reaches their peaks after the age of 50, a substantial number of women encounter the diagnosis of gynecologic cancer during their reproductive year. Thus, fertility preservation has an important role in good quality of life in adolescents and young adults. The gynecologic oncologists should thoroughly discuss the potentiate infertility with all patients and refer them to reproductive specialists as earliest as possible to broaden the fertility preservation options and reduce decisional regret. There are roles of fertility preservation treatment in appropriately selected patients such as early stage cervical cancer (IA1-IB1), early stage of endometrial carcinoma with well-differentiated endometrioid subtype, and some subtypes of ovarian cancer (epithelium ovarian cancer stage IA, epithelium ovarian cancer unilateral stage IC, malignant ovarian germ cell tumor, sex-cord stromal tumor, borderline ovarian tumor) which the fertility preserving procedure yields the optimal oncologic outcomes and acceptable obstetrics result. Patients should be insistently informed that the fertility sparing treatment is not the standard of care and accepted possibilities of impaired survival. The doctors should emphasize comprehensive surveillance and a complete surgical staging following family completion must be achieved.