Advances in the application of assisted reproductive technology in fertility preservation for female patients with malignant tumours of the reproductive systems
Rising female reproductive system malignant tumours and gonadotoxic treatments increase infertility risks in reproductive-age women, many of whom lack sufficient fertility preservation (FP) information. To review advances, status, challenges and ethical/legal aspects of assisted reproductive technology (ART) for FP in these patients. This narrative review synthesized literature from PubMed, Embase, Web of Science and Cochrane Library (keywords included ART, FP, reproductive system malignancies; literature deadline: January 2022), incorporating original studies, reviews, meta-analyses and guidelines from ASRM, ESHRE, ASCO. ART has advanced significantly in FP but faces gaps in protocol standardization, accessibility, clinical translation and psychosocial impacts, due to tumour/treatment heterogeneity and psychological factors. Multidisciplinary collaboration, provider training and evidence-based guidelines are needed; future research should focus on ovarian tissue transplantation safety, low-cost technologies, clinical translation of novel approaches, global protocols and ethical frameworks. ART facilitates FP, but standardized guidelines, multidisciplinary collaboration and long-term outcome research are essential to optimize care and patient autonomy.