The Current Trend of Fertility Preservation in Patients with Cervical Cancer

Author:

Liu Chih-Ku1,Huang Kuan-Gen2,Chen Ming-Jer13,Lu Chien-Hsing134,Hwang Sheau-Feng1,Sun Lou1,Hsu Shih-Tien156

Affiliation:

1. Department of Obstetrics, Gynecology and Women’s Health, Taichung Veterans General Hospital, Taichung, Taiwan

2. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Kwei Shan, Taiwan

3. Department of Obstetrics and Gynecology, School of Medicine, National Yang Ming University, Taipei City, Taiwan

4. Ph.D. Program in Translational Medicine and Rong Hsing Research Center for Translational Medicine, Institute of Biomedical Sciences, National Chung Hsing University, Taichung, Taiwan

5. Center for General Education, Ling Tung University, Taichung, Taiwan

6. Department of Obstetrics and Gynecology, School of Medicine, China Medical University, Taichung, Taiwan

Abstract

Abstract Although the incidence of most cancers increases with age, a considerable number of patients receive a diagnosis of cancer during their reproductive years. Young women wishing to get pregnant after cancer treatment should be provided consultation for fertility preservation and possible options. In patients with cervical cancer, hysterectomy is often inevitable because the uterus is located too close to the cervix. For young patients with cervical cancer who desire to get pregnant and whose lesion is confined to the cervix, sparing the uterus and, partially, the cervix should be prioritized as much as possible, while simultaneously ensuring favorable oncologic outcomes. In this review, we explore how to choose an adequate fertility-preserving procedure to achieve a balance between favorable oncologic outcomes and fertility and management during pregnancy after a radical trachelectomy in women with early-stage cervical cancer. For patients who require hysterectomy or radiation, evaluation of the ovarian condition and laparoscopic ovarian transposition followed by the use of artificial reproduction techniques and pregnancy by surrogacy should be discussed as options to achieve a successful pregnancy.

Publisher

Medknow

Subject

Obstetrics and Gynecology

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