Fertility-Sparing Treatments For Gynecological Cancers
What does a fertility-sparing treatment for gynecologic cancer entail?
It is estimated that almost 10-20% of women with gynecologic cancer are still of reproductive age. Additionally, women in developed countries delay their childbearing age more and more every day. While the recommended treatment for any type of cancer in the reproductive organs is incompatible with future pregnancies, numerous advances and investigations have been carried out in recent years. Therefore, nowadays fertility-sparing treatment IS POSSIBLE in selected women.
To do this, we evaluate each case in particular, and take into account the following factors:
Fertility-sparing treatment in a woman with gynecologic cancer means preserving at least one of the ovaries and the uterus. The factors we also take into account to select the patients are:
However, a key factor to consider is the possibility of ensuring a strict follow-up after the treatment with the goal of early detection of a possible disease recurrence. The patient selection criteria are very strict, and we have to talk to the patient and her family members about the advantages and disadvantages of each procedure.
What type of gynecologic tumors can benefit from a fertility-sparing treatment?
Fertility-sparing surgical procedures in women with cervical cancer include:
1- Cervical conization
2- Cervical conization + pelvic lymphadenectomy with or without chemotherapy
- Cervical conization.
- Pelvic lymphadenectomy: removal of the lymph nodes around the main arteries and veins of the pelvis.
3- Radical trachelectomy: the removal of only the uterine cervix and its surrounding tissue (parametria). After that, the vagina is re-attached to the uterine body. This is a high complexity surgery that requires special training that our team of gynecologic oncologists has. To do this, our surgical team can perform this surgery with a minimally invasive robotic technique to obtain the best results.
Fertility-sparing surgical procedures for women with ovarian and fallopian tube cancer include:
Unilateral Oophorectomy: the removal of the affected ovary alone.
Omentectomy: removal of a fatty tissue linked to the large intestine.
Pelvic and para-aortic lymphadenectomy: removal of the lymph nodes around the main arteries and veins of the abdomen and pelvis.
Appendectomy: Removal of the appendix in selected cases of ovarian cancer (mucinous histologic variant)
Multiple peritoneal biopsies: removal of small fragments (3-4 cm) in different regions (8-10) of the peritoneum. The latter is a tissue layer that covers intrabdominal organs and the abdominal wall.
Fertility-sparing surgical procedures in women with uterine-endometrial cancer include:
- High dose oral progestin
- Hormonal IUD (MIRENA) insertion and for one more year the administration of an intramuscular hormone (GnRH) which reduces estrogen production transiently in women.
- Removal of the tumoral lesion by hysteroscopy.
Request an appointment with a gynecologist, specialized medical oncologist in Valencia.
Specialist in fertility preservation with a special area for women’s health issues unit with a unit set up with the gynecological oncology surgery team focused on fertility preservation based in Valencia, Spain.
Special attention to high-risk pregnancies and malformation diagnosis with natural fertility treatments.
GYNECOLOGY AND OBSTETRICS
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Frequently Asked Questions about Fertility Conservative Treatment
Why preserve fertility?
Procedures related to maintaining fertility are used to help maintain a person’s ability to have children. A fertility preservation procedure is done before medical treatment that can cause sterility, such as radiation therapy or chemotherapy
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Doctor Lucas Minig Specialist in Conservative Fertility Treatment in Valencia, Spain
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