Fertility preservation in gynecologic cancer patients - Revista Brasileira de Ginecologia e Obstetrícia

Background

Gynecological cancer directly affects fertility, as treatment consists of surgical removal of the reproductive system and/or exposure to gonadotoxic agents. However, patients in early stages who meet established criteria can be treated with fertility-sparing surgeries and reach equivalent oncological results to those of traditional treatments. Fertility preservation techniques such as cryopreservation of oocytes, embryos and ovarian tissue may also be offered in some situations. The American Society of Clinical Oncology (ASCO) has published recommendations on fertility preservation with the aim of raising awareness on the topic, and, together with the American Society for Reproductive Medicine (ASRM), they recommend that patients of childbearing age with cancer undergo reproductive counseling. These patients have lower rates of regret, even when they choose to abandon conservative treatment.⁽⁾ Interest in fertility preservation has increased in recent decades, both because women delay pregnancy and because of the higher incidence of cancer in young people. The incidence rate of all cancers increased by 29% between 1973 and 2015 in adolescents and young adults of both sexes.⁽⁾ Cervical cancer in women aged 20-29 years increased annually by an average of 10.3% between 2000 and 2009.⁽⁾ Failure to advise cancer patients about the possibilities of preserving fertility may raise questions in the future; in some countries, this is already considered medical malpractice.

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