The real-world practice of fertility preservation for patients with epithelial ovarian cancer in Asian regions.
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OBJECTIVE: Fertility preservation (FP) is crucial for young women diagnosed with ovarian cancer (OvCa) due to the potential gonadal toxicity of chemotherapy. The Asian Society of Gynecologic Oncology (ASGO) Special Task Force on FP conducted a survey to evaluate FP practices across Asia, aiming to enhance cancer survivorship and fertility outcomes for adolescent and young adult (AYA) patients. METHODS: The survey included responses from 10 Asian regions, focusing on FP indications, surgical and chemotherapy practices, and ovarian function monitoring. Data were collected from representative institutions, and the study was approved by the Ethics Committee of Nagoya University. RESULTS: The findings showed significant variability in FP practices. Definitions of AYA patients varied across regions, affecting eligibility for FP interventions. Age limits for fertility-sparing surgery (FSS) ranged from 35 to 45 years across regions, with differing criteria for histological types and cancer stages. While all regions performed FSS, practices regarding surgery extent, chemotherapy management, and follow-up care were inconsistent. Seven regions had OvCa patient registries, but none maintained FP-specific registries. Regular ovarian function monitoring and the use of assisted reproductive technology were also unevenly implemented. CONCLUSION: The study highlights the need for standardized guidelines across Asia to harmonize oncologic safety with FP. Addressing these differences through collaborative efforts within ASGO is essential to improve patient outcomes and provide consistent care for AYA patients seeking FP during cancer treatment.