Advances in the application of assisted reproductive technology in fertility preservation for female patients with malignant tumours of the reproductive systems

BACKGROUND: Rising female reproductive system malignant tumours and gonadotoxic treatments increase infertility risks in reproductive-age women, many of whom lack sufficient fertility preservation (FP) information. OBJECTIVE: To review advances, status, challenges and ethical/legal aspects of assisted reproductive technology (ART) for FP in these patients. METHODS: This narrative review synthesized literature from PubMed, Embase, Web of Science and Cochrane Library (keywords included ART, FP, reproductive system malignancies; literature deadline: January 2022), incorporating original studies, reviews, meta-analyses and guidelines from ASRM, ESHRE, ASCO. RESULTS: ART has advanced significantly in FP but faces gaps in protocol standardization, accessibility, clinical translation and psychosocial impacts, due to tumour/treatment heterogeneity and psychological factors. Multidisciplinary collaboration, provider training and evidence-based guidelines are needed; future research should focus on ovarian tissue transplantation safety, low-cost technologies, clinical translation of novel approaches, global protocols and ethical frameworks. CONCLUSION: ART facilitates FP, but standardized guidelines, multidisciplinary collaboration and long-term outcome research are essential to optimize care and patient autonomy.