Breakthrough cancer therapies over the last few decades have significantly improved outcomes and long-term survival of cancer patients, particularly children and young adults. However, since many of the agents used in therapy are highly cytotoxic, cancer survivors often have to pay the price of a clutch of immediate and long-term side-effects.

Treatment for gynaecologic cancers often affects fertility in women of reproductive age. Almost all standard therapies for gynaecologic cancers, including surgical intervention, gonadotoxic chemotherapy and radiation therapy can threaten a woman’s childbearing potential, since these treatments impact the uterus and ovaries anatomically and functionally.

As it is, cancer seriously affects the psychological wellbeing of patients and weaken sexual function in many. Managing depression and anxiety and dealing with the erosion in quality of life present a mountain to climb. On top of that, the potential loss of fertility could sometimes be even more devastating than the cancer.

So, it is absolutely critical to try and preserve fertility in women affected by gynaecologic cancers. The recent development of fertility-preservation therapies to meet the childbearing demands of more than half of women aged between 18 and 40 holds out tremendous hope. Fertility-preservation techniques can play a critical role in improving the quality of life for women with gynaecologic cancers.

Fertility-preservation options should be discussed with premenopausal women with early-stage gynaecologic cancers immediately after diagnosis, and for women who wish to preserve fertility, during treatment planning. Mainly three modalities of fertility preservation can be offered to female patients prior to beginning their cancer treatment. These are embryo, oocyte and ovarian tissue cryopreservation.

Some main fertility preservation techniques

· Oocyte & embryo cryopreservation: Freezing of unfertilised eggs (oocytes) or fertilised embryos (eggs and sperm) is an oft-used and effective method to preserve fertility prior to chemotherapy or radiation.

· Ovarian tissue cryopreservation: Another viable option is freezing of strips of ovarian tissue, especially for young girls who are yet to begin menstruation.

· Fertility-sparing surgery: For a few cancers like cervical and endometrial cancers, FSS techniques like radical trachelectomy and progestin therapy can preserve fertility, while successfully treating the cancer.

· Ovarian transposition: Relocating the ovaries out of the pelvis before radiation therapy helps to shield them from radiation damage, preserving function.

· Fertility-protective agents: Using certain medication during chemotherapy can help protect future ovarian function.

To sum up

Fertility preservation is critical to a better quality of life. Access to fertility preservation helps patients achieve their family goals, improving overall wellbeing and providing renewed hope. It is particularly crucial for younger patients. A bunch of gynaecologic cancers affect women of reproductive age. For them, fertility preservation becomes a critical component of holistic cancer care.

FSS techniques have developed at a rapid clip in recent times, more so for young patients with gynaecologic cancers. Simultaneously, substantial progress in improving reproductive function in patients with such malignancies has been made, also in combined fertility treatment.