{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T09:14:01Z","timestamp":1775121241025,"version":"3.50.1"},"reference-count":49,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Oncologic surgery to the pelvis and post-surgery adjuvant therapy are dangerous to the reproductive potential of childbearing-aged women. Clinical practices in fertility preservation (FP) have become an essential aspect of multidisciplinary cancer care; however, uniform practices remain inconsistent among the different varieties of cancer and\/or areas. To systematically compare the fertility preservation procedures employed in women who have undergone pelvic oncologic surgery and to measure their reproductive and oncologic stages. This review focuses primarily on gynecologic pelvic malignancies and addresses fertility preservation strategies within the context of multimodal oncologic care, including surgery, chemotherapy, radiotherapy, and multidisciplinary decision-making. Methods: A systematic review was performed using PRISMA 2020 to investigate publications from to 2013\u20132025 in PubMed, Embase, Scopus, Cochrane Library, and Web of Science. The inclusion criteria were women of childbearing age with pelvic malignancies who underwent either fertility-sparing or cryopreservation procedures. PICO-based data mining was performed, and AMSTAR 2, NOS, and AGREE II methodological quality evaluation instruments were used. Mixed inductive\u2013deductive thematic analysis was used to synthesize the findings of the study. Results: A range of articles, including systematic reviews, cohort studies, and clinical guidelines, were included. Fertility-sparing surgery and cryopreservation were found to be as safe and oncologically effective as traditional therapy, with a five-year survival rate of more than 90. Cryopreservation maintained the functioning of the ovary in over 60 percent of the patients and recorded live delivery rates of up to 40 percent. Thematic analysis revealed five main spheres: oncologic safety, creation of FP approaches, psychosocial benefits, limiting access, and the necessity of standardized procedures. Conclusions: Fertility preservation can securely supplement oncologic treatment courses, favoring tumor traits and individual preferences. Unified reporting, extended follow-up, and equitable access are pertinent in maximizing results and reproductive self-corrective action among female cancer endocrine survivors. Fertility preservation should be considered as an integral component of multidisciplinary oncologic management in women with gynecologic pelvic cancers, extending beyond surgical approaches to include coordinated medical, reproductive, and supportive care.<\/jats:p>","DOI":"10.3390\/cancers18071142","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T07:57:55Z","timestamp":1775116675000},"page":"1142","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fertility Preservation Strategies in Women with Pelvic Gynecologic Malignancies Undergoing Multimodal Oncologic Treatment: A Systematic Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3296-0232","authenticated-orcid":false,"given":"Yasemin","family":"Dadas","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Nigde Omer Halisdemir University, 51120 Nigde, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6270-4340","authenticated-orcid":false,"given":"Gokalp","family":"Oner","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Istanbul Aydin University, 34295 Istanbul, T\u00fcrkiye"},{"name":"IVF Center, Private Dunyam Hospital, 38010 Kayseri, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1459-0606","authenticated-orcid":false,"given":"Enes","family":"Karaman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Faculty of Medicine, Nigde Omer Halisdemir University, 51120 Nigde, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2615-8474","authenticated-orcid":false,"given":"Durmus","family":"Ayan","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Faculty of Medicine, Nigde Omer Halisdemir University, 51240 Nigde, T\u00fcrkiye"},{"name":"Medical Biochemistry, Nigde Omer Halisdemir University Research and Training Hospital, 51100 Nigde, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hande Nur","family":"Doganay","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Clinic, Nigde Omer Halisdemir University Training and Research Hospital, 51100 Nigde, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ergul","family":"Bayram","sequence":"additional","affiliation":[{"name":"Medical Biochemistry, Nigde Omer Halisdemir University Research and Training Hospital, 51100 Nigde, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5059-4594","authenticated-orcid":false,"given":"Nazli Tunca","family":"Sanlier","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Clinic, Ciftlik State Hospital, 51800 Nigde, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Busra","family":"Kulular","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Clinic, Nigde Omer Halisdemir University Training and Research Hospital, 51100 Nigde, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1002\/ijgo.15229","article-title":"Techniques and endocrine\u2013reproductive outcomes of ovarian transposition prior to pelvic radiotherapy in gynecologic and non-gynecologic cancers: A systematic review and meta-analysis","volume":"165","author":"Genovese","year":"2024","journal-title":"Int. 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