Fertility preservation in gynecologic cancer

Subject. Management of patients with gynecologic cancer can now often be tailored to the extent of the disease and preservation of child-bearing ability and/or sexual function may be possible for certain women with early invasive disease. Method. A better understanding of the tumor-biology, and the consideration of different clinicopathologic factors, that bear prognostic significance in therapeutic modalities, will allow more and more individualization of treatment. Discussion. Management of young women with early gynecologic cancer should therefore be individualized with the risk of conservative therapy balanced against the dangers and advantages of more radical therapy. Experts in gynecologic oncology and infertility together with an informed patient and her family should make treatment decisions. Outcome. This article will review the conservative surgical management of early invasive cancers of the ovary, cervix and endometrium, in order to help preserve child-bearing capacity. In addition, management of gynecologic cancers diagnosed during pregnancy will also be discussed.