Fertility-sparing treatment in female genital cancer and breast cancer

Abstract

Postponed motherhood is the reason why many women are diagnosed with cancer before they make the decision to conceive a child, but only a small number of the affected patients will receive any information about treatmentrelated infertility. As far as female genital cancer is concerned, cervical cancer continues to be the most frequently diagnosed malignancy in women of childbearing age. In its early stages, it can be treated with surgical procedures which spare the genitals, i.e. surgical conization and vaginal radical trachelectomy with laparoscopic lymphadenectomy. The advantages of these procedures have been observed in our experience. Also, a successful conservative 6-month treatment of endometrial cancer limited to the mucous membrane with progestagens following curettage of the uterine cavity has been reported in the literature. This paper also presents our own experience with fertility-sparing surgical treatment of ovarian cancer with borderline malignancy and invasive IA stage. Breast cancer affects over 7% of all cancer patients under the age of 40. Pregnancy after breast cancer treatment has been shown to develop properly and both, pregnancy and breastfeeding have no influence on cancer relapse. Protective shields for the adnexa or relocation of the ovaries should be used during radiotherapy in patients who wish to preserve their fertility. In case of chemotherapy, application of GnRH analogs has shown promising results in preservation of the ovarian function. Also, the development of new assisted reproductive technology has offered an increasing number of alternatives for young cancer patients who wish to preserve their fertility.