Gynecologic surgery for benign disease: Preserving reproductive potential.

Area of Science:

• Reproductive Endocrinology and Infertility
• Gynecologic Surgery
• Women's Health

Background:

• Fertility preservation is crucial for reproductive-aged women with benign gynecologic disorders.
• Surgical interventions necessitate an individualized, evidence-based approach to minimize reproductive harm.
• Balancing disease control with fertility preservation is paramount in treatment strategies.

Purpose of the Study:

• To review current literature and develop recommendations for fertility-sparing surgical management of benign gynecologic disorders.
• To provide guidance on optimizing treatment strategies to minimize impact on future fertility.
• To establish evidence-based approaches for managing conditions affecting reproductive potential.

Main Methods:

• Comprehensive review of current literature by the FIGO Committee on Reproductive Endocrinology and Infertility.
• Analysis of evidence supporting refined surgical techniques and alternative fertility-sparing methods.
• Evaluation of treatment efficacy in balancing disease control and reproductive preservation.

Main Results:

• Medical management is preferred for pregnancy loss; hysteroscopic evacuation is safer than sharp curettage.
• Adhesion-reducing substances are recommended for hysteroscopic and abdominal procedures like myomectomy.
• Ovarian tissue preservation is vital in endometrioma surgery; oocyte cryopreservation should be discussed for recurrence risk.

Conclusions:

• Fertility-sparing treatment requires personalized, evidence-based strategies prioritizing reproductive potential.
• Refined surgical techniques and alternative methods are essential for minimizing reproductive harm.
• Continued refinement of these approaches is vital for women's reproductive health care.