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\nValentin Nicolae Varlas1,2, Roxana Georgiana Borș1,*, Rebeca Crețoiu3, Irina Bălescu4, Nicolae Bacalbașa5, Monica Cîrstoiu6  \nAuthor Affiliations  \n1. Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, Bucharest, Romania  \n2. Department of Obstetrics Gynecology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania  \n3. Department of Pituitary and Neuroendocrine Disorders, C.I. Parhon National Institute of Endocrinology, Bucharest, Romania  \n4. Department of Surgery, Ponderas Academic Hospital, Bucharest, Romania  \n5. Department of Visceral Surgery, Fundeni Clinical Institute, Bucharest, Romania  \n6. Department of Obstetrics and Gynecology, University Emergency Hospital Bucharest, Romania  \n* Corresponding Author:  \nRoxana Georgiana Borș  \nDepartment of Obstetrics and Gynaecology, Filantropia Clinical Hospital,  \nBucharest, Romania  \nEmail: [roxana_georgiana20@yahoo.com](roxana_georgiana20@yahoo.com)  \nDOI  \n10.25122/jml-2023-0203  \nDates  \nReceived: 6 June 2023  \nAccepted: 25 June 2023  \nABSTRACT  \nFertility preservation in cancer patients is currently based on either assisted reproductive technology or fertility-sparing surgery. Loss of fertility may be caused by excisional surgery associated with an adnexal or uterine pathology or secondary to gonadal insufficiency caused by chemotherapy or radiation. The counseling of these patients is very important, being carried out jointly by the oncologist, gynecologist, and reproductive medicine specialist. Reproductive surgery usually requires avoiding laparotomy to significantly reduce the formation of adhesions and trauma or tissue damage. This is done using standard laparoscopic surgery or robotic surgery (computer-assisted laparoscopy), a method increasingly used and accessible to all specialists who want to maintain the fertility of their patients with various oncological diseases.  \nKEYWORDS: fertility preservation, oncofertility, fertility-sparing surgery, young cancer patient, computer-assisted surgery, ovarian tissue transplantation; ovarian transposition; robotic surgery  \nINTRODUCTION  \nAdolescents and young adults (AYA) with cancer are often unaware that their life-preserving treatments can also threaten their future fertility potential [1–3] . Oncofertility (OF) is a growing area due to the increasing number of cancer survivors, the development of new oncologic therapies, the extension of treatments'duration, and the development and refinement of reproductive treatments [4] . The decision to protect fertility from the damaging effects of treatments, like radiation and chemotherapy, is complicated by the patient’s age, marital status, whether they can delay treatment, and, sometimes, the uncertainty of survival [5] . In women, chemotherapy is associated with a decrease in anti-Müllerian hormone (AMH) levels and an increase in follicle-stimulating hormone (FSH) levels, indicating a decline in ovarian reserve and potential impairment of fertility [6, 7] . Decreased estrogen levels leading to symptoms of menopause (such as hot flashes, vaginal dryness, or mood swings) are also frequent [8] . Biological markers serve not only as valuable tools for assessing infertility but also for investigating the recovery of ovarian function.  \nKim et al. concluded that post-chemotherapy AMH levels could bea relatively accurate predictor of ovarian function recovery, as indicated by the resumption of menstruation, in breast cancer patients with chemotherapy-induced amenorrhea [9] .  \nCurrent studies revealed the risk-stratified priority in cancer patients to optimize care among various malignancies; thus, Smith et al. [10] on breast cancer, Wallis et al. [11] on urologic cancers, Sica et al. [12] and Passamonti et al. [13] on onco-hematology, Martinelli et al. [14] and Colombo et al. [15] on gynecologic cancers","cbCairHDc7ohJXVT","https://ap.wps.com/l/cbCairHDc7ohJXVT","pdf",284532,"English","# Abstract\n# Introduction\n## Oncofertility and factors affecting fertility preservation\n## Biomarkers of ovarian reserve and recovery\n# Fertility-sparing surgical options by cancer type\n## Cervical cancer\n## Endometrial cancer\n## Ovarian cancer","[{\"question\":\"What are the main approaches to fertility preservation in cancer patients?\",\"answer\":\"Fertility preservation relies on either assisted reproductive technology or fertility-sparing surgery.\"},{\"question\":\"Why is fertility counseling especially important in young cancer patients?\",\"answer\":\"Counseling is crucial because fertility can be threatened by cancer treatments, and decisions depend on patient age, marital status, treatment timing, and survival uncertainty.\"},{\"question\":\"How does fertility-sparing surgery aim to reduce harm during treatment?\",\"answer\":\"It typically avoids laparotomy to significantly reduce adhesions and trauma or tissue damage, using standard laparoscopic surgery or robotic (computer-assisted) surgery.\"}]","Fertility-sparing surgery - a hopeful strategy for young women with cancer | PDF",1790240697,18]