A comprehensive narrative review of 28 global guidelines underscores a striking disconnect between evidence-based recommendations and real-world practice —fertility preservation is strongly endorsed for carefully selected patients with grade 1, stage IA endometrioid endometrial cancer, early-stage (<2 cm) cervical tumors without high-risk features, and borderline or malignant germ-cell ovarian tumors , yet referral rates to fertility specialists remain disproportionately low. The review maps out diagnostic criteria, eligibility thresholds, surgical and surveillance pathways, and reveals significant variation in recommendations for higher-stage disease and uncommon histologies—areas where evidence is sparse and practice remains non-uniform.
By synthesizing consensus points and highlighting gaps where prospective data are urgently required, the authors emphasize the need for structured,…
