[Fertility preservation in gynecologic cancer]

Recent advances in both the staging and the understanding of the natural history of gynecologic cancers have led to new approaches to treatment. The treatment can now often be tailored to the extent of the disease, and preservation of child-bearing ability and/or sexual function may be possible for certain women with early invasive cancers of the ovary, cervix, endometrium, vagina and vulva. Better understanding of the tumour biology and clinicopathologic factors of prognostic significance will allow for individualization of treatment. Management of patients with early gynecologic cancer should be individualized with the risks of conservative therapy balanced against the dangers and advantages of more radical therapy. Specialists in gynecologic oncology and infertility together with an informed patient and her family should make treatment decisions. In this article we present an overview of the therapeutic management of early invasive cancers of the ovary, cervix and endometrium, and present guidelines that may help preserve childbearing capacity.