Fertility preservation in the management of gynecologic cancers.

Quality of life has become a very important issue in deciding the extent of surgical procedures for patients affected with a variety of cancers. For instance, in recent years more attention has been given to preserving organ function (eg, limb-preserving surgery in melanoma), cosmesis (eg, in breast cancer), and now reproductive function. Indeed, as cancer treatment has improved the rate of survival associated with several neoplasias, cancer survivors are more and more interested in preserving fertility potential. This article focuses on new and innovative techniques or approaches to treat gynecologic cancers while minimizing the negative fertility effects of cancer treatment. In particular, the radical trachelectomy procedure in cervical cancer, hormonal treatment of early endometrial cancer, conservative surgical management of early-stage epithelial ovarian cancer, and novel assisted reproductive technologies for women with impaired ovarian function after cancer treatment are discussed.