Oncofertility Research: A Review of the Literature.

Abstract

Objective: To examine publication trends pertaining to fertility-sparing management in patients of reproductive age with gynecological malignancies. Methods: Ovid MEDLINE was used to aggregate all publications on gynecological cancers and fertility between 1946 and 2022. Original research, reviews, case series/reports, and editorials were included. Publication information was extracted from Ovid MEDLINE. Individual authors' subspecialty credentials were individually reviewed and confirmed. Descriptive statistics were generated. Results: The initial query generated 2,057 publications. Of these, 1,057 (51.4%) publications met search criteria, with the first study being published in 1991 and with 16.6% published in the last 2 years. Only 34 (5.5%) studies were published with collaboration between reproductive endocrinology and infertility (REI) and gynecological oncology physicians in the United States. Gynecological oncologists comprised most senior authors (50.9%), followed by REI specialists (18.6%). Topics of the publications centered on fertility-sparing surgical management (43.1%), medical management of gynecological malignancies (11.3%), and oocyte/ovarian tissue preservation (6.0%). Most publications focused on ovarian malignancies (349, 33.3%), followed by cervical cancer (299, 28.5%), and uterine/endometrial cancer (258, 24.6%). While the number of publications regarding fertility-sparing management has increased over the last 30 years, the majority are retrospective studies and case reports/series. In the last 10 years, only five studies were randomized controlled trials. Conclusions: There is an urgent need for more prospective research in oncofertility. While fertility care in the setting of gynecological cancer is a collaborative effort between the specialties of gynecological oncology and REI, this partnership is not reflected in the authorship of current literature.