Narrative review of fertility preservation techniques for women with malignant tumors in China

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Frontiers in Medicine Published May 25, 2026 Medically reviewed May 25, 2026 DOI ↗ By Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

Key Takeaway

Consider that fertility preservation techniques show variable success rates; multidisciplinary support is crucial.

This narrative review, not a systematic synthesis, explores fertility preservation techniques for women of childbearing age with malignant tumors, with a focus on Chinese practices and selective international comparisons. The authors discuss methods including oocyte freezing, embryo freezing, ovarian tissue freezing, and in vitro maturation.

Key findings from the reviewed literature include survival rates of frozen mature oocytes after thawing of 80%-90%, a cumulative live birth rate with oocyte freezing of approximately 33%, and a pregnancy rate with frozen-thawed embryo transfer higher than with fresh embryos. For ovarian tissue transplantation, the sustained pregnancy/live birth rate is approximately 37.7%, but there is a risk of tumor cell reintroduction of about 1%, highest in leukemia patients. In vitro maturation yields a live birth rate of 8.9%. The review also notes that 66%-100% of patients express a need for fertility information.

Limitations include the narrative design, which does not provide a systematic synthesis of all evidence, and a focus on Chinese practices that may limit generalizability. The authors do not report funding or conflicts of interest. No causal claims are made, and results should not be treated as primary data.

Practice relevance: The review underscores the importance of multidisciplinary collaboration, ethical regulations, and patient-centered decision support in fertility preservation for cancer patients. Clinicians should interpret these findings cautiously given the narrative nature of the review.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

BackgroundApproximately 2 million women of childbearing age worldwide are diagnosed with malignant tumors each year, with tens of thousands of them facing the risk of fertility loss due to cancer treatment. With the advancement of tumor treatment technology, patient survival rates have significantly improved, and the demand for fertility preservation is increasing. However, tumor treatment damages ovarian function through various mechanisms, leading to temporary or permanent infertility. How to maximize the protection of fertility while controlling tumors has become a key issue in the overall management of tumors. Our review focuses on the ethical and regulatory landscape in China, while drawing selective international comparisons.MethodThis article provides a comprehensive narrative review of the pathological mechanisms of fertility damage in women with malignant tumors of childbearing age, summarizes the effectiveness and safety of current major fertility preservation techniques (oocyte freezing, embryo freezing, ovarian tissue freezing, in vitro maturation techniques), analyzes the psychological challenges and family communication difficulties faced by patients in the decision-making process, explores the construction path of multidisciplinary collaboration models, and focuses on ethical and legal gaps in clinical practice.Result① The survival rate of frozen mature oocytes after thawing can reach 80% -90%, with a cumulative live birth rate of about 33%. However, unmarried patients face legal gray areas such as cross institutional transportation of frozen eggs and the right to dispose of them after death; ② Embryo freezing technology is the most mature, and the pregnancy rate of frozen thawed embryo transfer is higher than that of fresh embryos, but it is only suitable for married patients, and their reproductive autonomy is limited after divorce; ③ Ovarian tissue freezing is suitable for patients in need of emergency treatment or pre puberty, with a sustained pregnancy/live birth rate of approximately 37.7% after transplantation, but there is a risk of tumor cell reintroduction (approximately 1%, with leukemia patients having the highest risk); ④ In vitro maturation technology does not require ovarian stimulation and does not delay treatment, but the live birth rate (8.9%) is significantly lower than that of mature egg freezing; ⑤ Patients generally have a need for fertility information (66% -100%), and anxiety and depression affect decision-making ability, requiring specialized and repetitive counseling and psychological intervention; ⑥ Multidisciplinary collaboration can optimize treatment timing, balance tumor control and fertility protection, but even if doctors have positive cognition, the actual referral rate is still not ideal; ⑦ Ethical challenges involve issues such as decision-making autonomy, the right to dispose of frozen gametes, long-term follow-up of offspring health, and social equity accessibility. However, there are divergent attitudes among the public towards the use of frozen gametes for research, emphasizing patients’ calls for inclusion in medical insurance and legal regulation.ConclusionFertility preservation requires the establishment of a patient-centered decision support system, incorporating psychological assessment and family communication into the counseling process; Establishing an institutionalized multidisciplinary collaboration model to eliminate the practical gap from cognition to referral; Improve ethical regulations and legal frameworks, clarify gray areas such as egg freezing, cross institutional transportation, and post death disposal rights for unmarried patients; Establish a long-term follow-up and social support network to accumulate offspring health and safety data. Only through multidimensional collaboration of technological application, ethical considerations, standardized management, and social support can we protect the fertility hope and dignity of cancer patients while curing the disease.