Chinese Medical E-ournals Database
Adv Search
中华妇幼临床医学杂志(电子版)

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2025, Vol. 21 ›› Issue (03): 266 -270. doi: 10.3877/cma.j.issn.1673-5250.2025.03.003

Expert Editorial

Fertility preservation in young patients with gynecological malignancies: clinical practices and challenges

Qiuyi Wang, Wei Huang†()   

  1. Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2025-02-02 Revised:2025-05-28 Published:2025-06-01
  • Corresponding author: Wei Huang
  • Supported by:
    National Key Research & Development Program of China(2023YFC2705502)
HTML ( ) PDF ( )

Fertility preservation (FP) in young women with gynecological malignancies has emerged as a critical component of clinical decision-making. With the increasing incidence of these malignancies among young women and advancements in therapeutic strategies, there is a growing demand for FP options among them. Current FP methodologies include embryo cryopreservation, oocyte vitrification, ovarian tissue cryopreservation (OTC), and in vitro maturation (IVM) of immature oocytes. This review systematically examines the clinical necessity of FP, elucidates standardized protocols for its implementation, and evaluates key technological innovations, aiming to provide evidence-based guidance for optimizing FP integration into gynecologic oncology practice and how to deal with the challenges in clinic.

Key words: Neoplasms, second primary, Genital neoplasms, female, Fertility, Embryo implantation, Fertility preservation, Embryo freezing, Oocyte freezing, Ovarian tissue cryopreservation
[1]
Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249. DOI: 10.3322/caac.21660.
[2]
Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024[J]. CA Cancer J Clin, 2024, 74(1): 12-49. DOI: 10.3322/caac.21820.
[3]
Oktay K, Harvey BE, Partridge AH, et al. Fertility preservation in patients with cancer: ASCO clinical practice guideline update[J]. J Clin Oncol, 2018, 36(19): 1994-2001. DOI: 10.1200/JCO.2018.78.1914.
[4]
Taylan E, Oktay K. Fertility preservation in gynecologic cancers[J]. Gynecol Oncol, 2019, 155(3): 522-529. DOI: 10.1016/j.ygyno.2019.09.012.
[5]
Di Nisio V, Daponte N, Messini C, et al. Oncofertility and fertility preservation for women with gynecological malignancies: where do we stand today？[J]. Biomolecules, 2024, 14(8)：943. DOI: 10.3390/biom14080943.
[6]
Schuurman T, Zilver S, Samuels S, et al. Fertility-sparing surgery in gynecologic cancer: a systematic review[J]. Cancers (Basel), 2021, 13(5)：1008. DOI: 10.3390/cancers13051008.
[7]
Markowska A, Antoszczak M, Markowska J, et al. Gynotoxic effects of chemotherapy and potential protective mechanisms[J]. Cancers (Basel), 2024, 16(12)：2288. DOI: 10.3390/cancers16122288.
[8]
Ghadjar P, Budach V, Köhler C, et al. Modern radiation therapy and potential fertility preservation strategies in patients with cervical cancer undergoing chemoradiation[J]. Radiat Oncol, 2015, 10: 50. DOI: 10.1186/s13014-015-0353-4.
[9]
Practice Committee of the American Society for Reproductive Medicine. Fertility preservation in patients undergoing gonadotoxic therapy or gonadectomy: a committee opinion[J]. Fertil Steril, 2019, 112(6): 1022-1033. DOI: 10.1016/j.fertnstert.2019.09.013.
[10]
ESHRE Guideline Group on Female Fertility Preservation. ESHRE guideline: female fertility preservation[J]. Hum Reprod Open, 2020, 2020(4): hoaa052. DOI: 10.1093/hropen/hoaa052.
[11]
Su HI, Lacchetti C, Letourneau J, et al. Fertility preservation in people with cancer: ASCO guideline update[J]. J Clin Oncol, 2025, 43(12): 1488-1515. DOI: 10.1200/JCO-24-02782.
[12]
中华医学会生殖医学分会. 生育力保存中国专家共识[J]. 生殖医学杂志，2021, 30 (9): 1129-1134. DOI: 10.3969/j.issn.1004-3845.2021.09.002.
[13]
Melin J, Holopainen E, Savolainen-Peltonen H. Fertility counselling and fertility preservation among early onset female cancer patients-A Finnish register-based study[J]. Cancer Med, 2024, 13(3): e7034. DOI: 10.1002/cam4.7034.
[14]
中国优生科学协会肿瘤生殖学分会，中国医师协会微无创医学专业委员会妇科肿瘤学组，中国医院协会妇产医院分会妇科肿瘤专业学组. 卵巢恶性肿瘤保留生育功能的中国专家共识(2022年版)[J]. 中国实用妇科与产科杂志，2022, 38(7): 705-713. DOI: 10.19538/j.fk2022070110.
[15]
Woolderink JM, De Bock GH, de Hullu JA, et al. Characteristics of Lynch syndrome associated ovarian cancer[J]. Gynecol Oncol, 2018, 150(2): 324-330. DOI: 10.1016/j.ygyno.2018.03.060.
[16]
Nikiforov D, Junping C, Cadenas J, et al. Improving the maturation rate of human oocytes collected ex vivo during the cryopreservation of ovarian tissue[J]. J Assist Reprod Genet, 2020, 37(4): 891-904. DOI: 10.1007/s10815-020-01724-7.
[17]
Fraison E, Huberlant S, Labrune E, et al. Live birth rate after female fertility preservation for cancer or haematopoietic stem cell transplantation: a systematic review and Meta-analysis of the three main techniques; embryo, oocyte and ovarian tissue cryopreservation[J]. Hum Reprod, 2023, 38(3): 489-502. DOI: 10.1093/humrep/deac249.
[18]
Kuang Y, Hong Q, Chen Q, et al. Luteal-phase ovarian stimulation is feasible for producing competent oocytes in women undergoing in vitro fertilization/intracytoplasmic sperm injection treatment, with optimal pregnancy outcomes in frozen-thawed embryo transfer cycles[J]. Fertil Steril，2014，101(1)：105-111. DOI：10.1016/j.fertnstert.2013.09.007.
[1] Ruichao Zhang, Shiyuan Yang, Kuangmeng Li, Jie Jiang, Chang Liu, Ligang Cui. Practices for quality control in male reproductive ultrasound[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2025, 22(05): 434-443.
[2] Xuewei He, Hua Lian, Ning Wang, Xiaohong Fang. Clinical application of real-time dynamic three-dimensional painless tubal contrast-enhanced ultrasonography[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2025, 22(01): 39-45.
[3] Siyu Cao, Chengyu Zhao, Jinke Li. Considerations on fertility sparing strategies in childbearing age patients with borderline and malignant ovarian tumors[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2025, 21(03): 271-277.
[4] Min Jiang, Aihua Chen. Interaction of thyrotropin levels on gonadotrophin initiation day and body mass index on ovulation promoting high quality embryo formation in infertile patients with polycystic ovary syndrome[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2025, 21(02): 171-179.
[5] Mengting He, Jia Liao, Jincheng Zhang, Shawei Sa, Shaorong Xu, Xia Zhao, Qianhong Ma. Pregnancy outcomes and theoretical peak number of treatment cycle of in vitro fertilization-embryo transfer in infertile women with low anti-Mullerian hormone[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(06): 659-667.
[6] Fanying Zeng, Jie Ruan, Xinghui Liu, Guolin He. Current status of perinatal medicine advances under the new reproductive situation and coping strategies in prenatal care[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(05): 519-524.
[7] Xin Li, Yi Wei, Juan Zhang, Juanjuan Zhang, Xiufeng Ling, Chun Zhao, Mianqiu Zhang. Influencing factors on clinical pregnancy outcomes of frozen-thaw embryo transfer cycle in women of advanced age[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(03): 276-283.
[8] Yi Wei, Yuxi Zhou, Ye Yang, Xiufeng Ling, Chun Zhao. Current research status on roles of microRNA on endometrial receptivity[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(03): 266-270.
[9] Qingzhuo Gao, Yifan Kang, Zhihong Wang. Current research status of clinical studies on monopronuclear embryos in in vitro fertilization cycles[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2024, 20(03): 260-265.
[10] Li Wang, Yueying Wang, Fen Zhou, Yukun Guo, Lina Wei. Current research status in effect of gonadotropin-releasing hormone antagonist on endometrial receptivity[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(06): 629-635.
[11] Wenrong Dai, Lijuan Zhao, Zhihui Li. Research progress of influence of extracellular vesicles on embryo implantation[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(05): 616-620.
[12] Yuanyuan Chen, Hongli Yan. Genetic blockade in hereditary colorectal cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2024, 13(01): 1-5.
[13] Jie Yuan, Yuqi Qiao, Yandong Li. Efficacy of letrozole combined with metformin and dydrogesterone in treatment of polycystic ovarian syndrome with infertility[J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(04): 343-347.
[14] An'an Chen, Ta Hu. Analysis of detection results of ureaplasma urealyticum, mycoplasma hominis and chlamydia trachomatis infection in infertile women in Guangzhou area[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2025, 13(02): 79-83.
[15] Ya Tan, Li Lu. Cox regression analysis of factors related to natural pregnancy after four-dimensional hysterosalpingocontrast sonography in women with infertility[J]. Chinese Journal of Diagnostics(Electronic Edition), 2025, 13(01): 26-31.
Viewed
Full text


Abstract

Copyright © Chinese Medical Association, Chinese Medical Multimedia Press  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号