Indications and teaching of fertility preservation in the surgical management of gynecologic malignancies: European perspective

Young women affected by a malignant tumor have to cope, after the announcement of diagnosis, with the treatment and its secondary effects. Indeed, some of them may definitively impact on their fertility potential. Especially in pelvic tumors, treatments are more or less mutilating, either by a direct surgical resection of pelvic organs or by destruction of their functioning after chemotherapy or radiation therapy. Surgeons are often at the front line in the management of gynecologic tumors. It is important for them to be aware not only of the Surgical techniques currently available to preserve fertility, but as well of their indications and limits, according to the tumor type or its treatment. This knowledge will enable them to deliver fair information to the patient or couple, keeping in mind that, multidisciplinarity is of a paramount importance and referring a patient to a more experienced team, is sometimes the best solution. Through a literature review, we report on the most recent results of the different options available today according to cancer localization as well as some opinions concerning indications, management, organization of care, and teaching of these techniques. (C) 2009 Elsevier Inc. All rights reserved.