News

Gynaecological cancers in the era of fertility preservation - A new special issue from ecancer

6 May 2020
Gynaecological cancers in the era of fertility preservation - A new special issue from ecancer

ecancer has published a new special issue today that offers a comprehensive and multidisciplinary overview of the techniques available to preserve fertility for women diagnosed with gynaecological cancers.

In the editorial accompanying the special issue, the Special Issue Guest Editor, Dr Valentina Lucia La Rosa from the University of Catania discusses how preservation of fertility is a key factor in quality of life for women who recover from gynaecological cancers.

Dr La Rosa states that: “This is a critical and timely collection because studies have shown that the prospect of becoming a mother after cancer may significantly improve compliance with treatments and recovery times, and consequently, fertility preservation has fundamental importance for women with gynaecological cancer.”

The editorial reflects on the fact that as progress in the field has significantly increased survival rates from gynaecological cancers, ensuring an adequate quality of life for patients has become a top priority for clinicians and fertility preservation is key to this for younger patients.

Around 21% of the women diagnosed with gynaecological cancer will be under 40 and still in their reproductive years. The problem is exacerbated because with so many first pregnancies now occurring later in life, more patients are being diagnosed before they have become mothers for the first time.

Different treatment options have a significant impact on a woman's fertility. Whilst surgical management of ovarian, cervical and endometrial cancers requires a radical approach which often consists of hysterectomy and bilateral oophorectomy, chemotherapy and radiotherapy may severely decrease ovarian reserve.

In this regard, it is important to consider that the psychological well-being of women is strongly affected by the experience of gynaecological cancer and its treatments and it has been widely documented how the potential loss of fertility may be a source of distress comparable to cancer itself for the patient.

Dr La Rosa continues “The literature shows that when patients discuss fertility issues with their clinician and are provided adequate fertility preservation counselling this can reduce distress and improves satisfaction levels and quality of life.”

The editorial concludes that several fertility preservation techniques are available today but the choice of the most suitable one should take into account many factors, such as diagnosis, age, presence of a partner, financial resources, and time factors. Fertility-sparing surgery has made great progress, whilst embryo cryopreservation, requiring in vitro fertilisation and a male partner, seems to be the most effective fertility preservation technique.

In cases of patients who do not require surgical treatment of fertility but undergoing adjuvant therapy with radiation therapy, ovarian transposition and cryopreservation of oocytes or embryos are the preferred treatments.

You can read the full editorial here and access the complete special issue here.

Watch Dr Fedro Peccatori introduce the Special Issue with an interview with ecancer here.