Preface

The recent results obtained in the treatment of the more frequent type of neoplasia in the young and in childbearing age adults, have determined a rising request for conservative treatment aimed to maintain possibility to conceive.

In Italy, cancer represent the first cause of death for female in the reproductive age and the 10% out off 129.000 new cases diagnosed every year are of reproductive age.

Considering the tumour that occur in the children, the five year survival is equal to 78%. As a consequence of the high number of long-term survivors, in the follow-up of these patients we have to consider not only the absence of recurrences but also the implications due to the therapies and it is necessary to evaluate the impact on their fertility development.

In a great percentage of cases these patients have just a short time to preserve their fertility before to pass surgery or to start chemotherapy or radiotherapy; as a consequence, we can affirm that to preserve fertility in the young population affected by neoplasia it has to be considered an “endocrine-reproductive emergency”. A patient affected by a neoplasia in the fertile age would be treated and followed-up by a team of specialists: gynaecologist-oncologist, medical oncologist, radiotherapist and in some cases an expert in medical assisted procreation with the end to evaluate the impact of any therapy on the fertility.

In the last ten year literature there is a rising number of studies conducted to answer the question how to preserve fertility in patient affected by a neoplasia during childbearing age. To answer this question it is important to consider the necessity to cure the woman, to preserve her fertility, to give information both on the effect of neoplasia and neoplasia treatments on the pregnancy. Patient have to be informed on the possible treatment alternatives with the end to be less aggressive to the reproductive function but, in the same time, giving same results in term of survival.

Many retrospective studies conducted on this topic have analyzed the pregnancy outcome of single patients affected by a neoplasia and the results were referred to type of therapy, the frequency and outcome of pregnancies in women affected by neoplasia, but very few we know on what happen to our population affected by neoplasia in term of pregnancies, miscarriage or volunteer abortion considering a long period of time. In fact, only if we prospectively follow this population, we may better understand the patient requests at the time of primary treatment.

Aim of this Book is not only to describe the state of the art on fertility preservation in the patients affected by neoplasia, but also to present and to discuss the possibility to conceive and to deliver after oncologic treatments.We believe the eBook is addressed first of all to Medical Doctors and Nurses devoted to the oncologic field; we are sure that it will be of interest also for Medically Assisted Pregnancy Specialists and General Practitioners.