Advances in fertility-preservation surgery: navigating new frontiers

For female patients facing fertility-impairing treatment for select cancers and other medical conditions, fertility-preserving surgeries have evolved to meet the needs of those who desire fertility preservation. Over the last 70 years, advances in surgical options for fertility preservation have vastly increased in scope and availability. Major breakthroughs in fertility-preservation surgeries include the development of ovarian transposition procedures as well as uterine fixation; both procedures move these vital reproductive organs away from radiation fields to help protect and preserve future fertility. Since the first transplantation of thawed cryopreserved ovarian tissue 20 years ago, there have been major advances in techniques to optimize outcomes. Additionally, surgeries specific for gynecologic malignancies, including radical trachelectomy, have allowed for the preservation of vital reproductive organs. This juncture between innovation and technology resulting in fertility-sparing surgical options for cancer patients illustrates both surgical creativity and continued commitment to develop new techniques, while improving those already in practice. This review explores current advancements in fertility-preserving reproductive surgery, highlighting significant historical landmarks and recent major developments.