FERTILITY PRESERVING SURGERIES
Due to the growing trend of delayed childbearing, fertility preservation has emerged as a significant concern for young women diagnosed with gynecological cancer.
In selected cases of cervical, endometrial, and ovarian cancer, successful attempts have been made at fertility-sparing treatments. Gynecologists should be well-versed in fertility-preserving options for women with gynecological malignancies. These options include shielding techniques to mitigate radiation damage, fertility preservation strategies during cytotoxic treatments, cryopreservation of reproductive tissues, assisted reproduction techniques, and fertility-sparing surgical procedures.
One such procedure is radical vaginal trachelectomy with laparoscopic lymphadenectomy, which has been established as an oncologically safe method for preserving fertility. Widely accepted as a surgical approach for small early-stage cervical cancers, this technique allows for the preservation of fertility while effectively treating the disease. Similarly, selected cases of early-stage ovarian cancer may be managed with unilateral salpingo-oophorectomy and surgical staging.
For young women with endometrial cancer, hysteroscopic resection and progesterone treatment are utilized to maintain fertility and avoid surgical menopause. However, careful patient selection and comprehensive counseling are crucial, encompassing oncologic, psychological, reproductive, and obstetric considerations. By ensuring appropriate patient selection and thorough counseling, gynecologists can navigate the complexities of fertility preservation in women with gynecological malignancies, ultimately offering them the opportunity to pursue parenthood while managing their cancer treatment.