Journal of Cancer Survivorship

, Volume 13, Issue 2, pp 269–281 | Cite as

Reproductive outcomes following treatment for a gynecological cancer diagnosis: a systematic review

  • Brigitte Gerstl
  • Elizabeth Sullivan
  • Marcus Vallejo
  • Jana Koch
  • Maximilian Johnson
  • Handan Wand
  • Kate Webber
  • Angela Ives
  • Antoinette AnazodoEmail author



Fertility treatments are available for women diagnosed with a gynecological malignancy, which is important for women who desire a biological family subsequent to treatment. The objective of this study was to report reproductive outcomes following fertility-sparing treatment for a gynaecological cancer.


Electronic databases were searched to identify studies that reported on reproductive outcomes after treatment for a gynecological malignancy.


In total, 77 studies were included which reported on reproductive outcomes after treatment for cervical cancer, endometrial cancer, gestational trophoblastic disease, and ovarian cancer. The main treatments included vaginal or abdominal radical trachelectomy, progestin therapy, salpingo-oophorectomy, and chemotherapy. The mean age at diagnosis for the study population and at birth were 30.5 years and 30.3 years, respectively. There were 4749 pregnancies (42%) reported for the included studies, with a miscarriage rate of 15% and a medical termination rate of 5%. The live birth rate was 74% with a 10% preterm rate.

Implications for Cancer Survivors

Patients should be offered timely discussions, information, and counseling regarding the impact of gynecological cancer treatment on a patient’s fertility. Furthermore, fertility-sparing strategies and fertility preservation should be discussed prior to starting treatment.


Gynecological neoplasms Survivors Pregnancy Oncofertility Systematic review 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human rights and the welfare of animals

This article does not contain any studies with human participants or animals performed by any of the authors. The current study was a systematic review of existing studies that did not involve collection of new data.

Informed consent

The current study was a review of existing studies that did not involve collection of new patient data; hence, informed consent was not obtained from individual participants for the purpose of this manuscript.

Editorial independence

The authors are editorially independent of any funding sources. The views and interests of the funding sources have not influenced the conclusions reported in this document.

Ethical approval

This article is a systematic review of scholarly literature and did not require involvement of human participants.


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Copyright information

© Crown 2019

Authors and Affiliations

  • Brigitte Gerstl
    • 1
    • 2
  • Elizabeth Sullivan
    • 3
  • Marcus Vallejo
    • 2
  • Jana Koch
    • 4
  • Maximilian Johnson
    • 5
  • Handan Wand
    • 1
  • Kate Webber
    • 6
    • 7
  • Angela Ives
    • 8
  • Antoinette Anazodo
    • 2
    • 6
    • 9
    Email author
  1. 1.Department of Biostatistics, The Kirby InstituteUniversity of New South WalesSydneyAustralia
  2. 2.Kids Cancer CentreSydney Children’s HospitalSydneyAustralia
  3. 3.Australian Centre for Public Health and Population Health Research, Faculty of HealthUniversity of Technology SydneySydneyAustralia
  4. 4.Department of EpidemiologyTechnical University of MunichMunichGermany
  5. 5.Brighton and Sussex Medical SchoolRoyal Sussex County HospitalBrightonUK
  6. 6.Nelune Comprehensive Cancer CentrePrince of Wales HospitalSydneyAustralia
  7. 7.Prince of Wales Clinical SchoolUniversity of New South WalesSydneyAustralia
  8. 8.Cancer and Palliative Care Research and Evaluation UnitUniversity of Western AustraliaCrawleyAustralia
  9. 9.School of Women’s and Children’s Health, Discipline of PaediatricsUniversity of New South WalesSydneyAustralia

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