title: Fertility-preserving surgical procedures, techniques.
abstract: As a result of the trend toward late childbearing, fertility preservation has become a major issue in young women with gynaecological cancer. Fertility-sparing treatments have been successfully attempted in selected cases of cervical, endometrial and ovarian cancer, and gynaecologists should be familiar with fertility-preserving options in women with gynaecological malignancies. Options to preserve fertility include shielding to reduce radiation damage, fertility preservation when undergoing cytotoxic treatments, cryopreservation, assisted reproduction techniques, and fertility-sparing surgical procedures. Radical vaginal trachelectomy with laparoscopic lymphadenectomy is an oncologically safe, fertility-preserving procedure. It has been accepted worldwide as a surgical treatment of small early stage cervical cancers. Selected cases of early stage ovarian cancer can be treated by unilateral salpingo-ophorectomy and surgical staging. Hysteroscopic resection and progesterone treatment are used in young women who have endometrial cancer to maintain fertility and avoid surgical menopause. Appropriate patient selection, and careful oncologic, psychologic, reproductive and obstetric counselling, is mandatory.
authors.affiliation: Surgical Oncology Department, Claudius Regaud Comprehensive Cancer Center, Toulouse, France. martinez.alejandra@claudiusregaud.fr
authors.forename: Alejandra
authors.initials: A
authors.lastname: Martinez
authors.forename: Mathieu
authors.initials: M
authors.lastname: Poilblanc
authors.forename: Gwenael
authors.initials: G
authors.lastname: Ferron
authors.forename: Mariolene
authors.initials: M
authors.lastname: De Cuypere
authors.forename: Eva
authors.initials: E
authors.lastname: Jouve
authors.forename: Denis
authors.initials: D
authors.lastname: Querleu
mesh_terms: D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D006801:Humans; D059351:Organ Sparing Treatments / Q000379:methods*; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*