In China, the treatment of gynecological malignant tumors with preservation of fertility is getting more and more attention, and a lot of related researches are in progress. However, in clinical diagnosis and treatment, the treatment methods are various, and the therapeutic effect is not the same, clinicians often feel very difficult, in order to change this situation as soon as possible, and better provide patients with scientific and effective diagnosis and treatment programs and medical services, therefore, the development of the corresponding expert consensus or diagnosis and treatment guidelines is imperative. According to the specific situation of China, we have drawn on the experience of ASCO in formulating clinical guidelines for fertility preservation, summarized and analyzed the important literature in relevant databases, and reached a consensus through the full discussion of experts in gynecologic oncology, reproductive medicine, and gynecologic endocrinology to formulate the first Chinese clinical guidelines for fertility preservation of gynecologic malignant tumors. The formulation of this guideline can provide an important basis for clinicians to make decisions and better serve patients; at the same time, it can also educate and guide patients with relevant medical knowledge and encourage them to actively participate in multicenter clinical trials, which plays a positive role in promoting the improvement of treatment options for fertility preservation of gynecologic malignant tumors in China. I. Treatment of gynecological malignant tumors with preservation of fertility function (I) Cervical cancer With the popularization of cervical cancer screening, the number of early-stage patients has increased, and their age tends to be younger, and with the opening up of national family planning policy, many young patients with cervical cancer aspire to preserving their fertility function. Surgery is the mainstay of fertility preservation treatment for cervical cancer. 1. Cervical conization: the indications for cervical conization are: (1) stage Ia1 and stage Ia2 squamous cervical cancer; (2) stage Ia1 adenocarcinoma of the cervix. Many literatures report that early stage invasive carcinoma of the uterine cervix can be successfully treated by conization of the uterine cervix as long as the depth of infiltration is ≤3 mm and there is no lymphovascular space involvement. Precautions: (1) Positive margins, lymphovascular space involvement, interstitial involvement of the cervix and multicentricity of the lesion are the decisive factors for residual or recurrent lesions after cervical conization. Therefore, the results of postoperative pathologic examination must clearly state these 4 aspects, which is the basis for formulating the patient’s postoperative management plan after cervical conization. (2) In order to avoid residual lesions, the appropriate range of conization should be selected based on the patient’s age, colposcopic findings, and the pathological type of the tumor. In general, the width of resection should be 0.3 cm outside the lesion, and the cone height should be extended to 2.0-2.5 cm of the cervical canal, and the squamocolumnar junction must be resected together during conization. (3) For margin-positive minimally invasive carcinoma of the cervix, the International Federation of Gynecology and Obstetrics (FIGO) recommends that another conization biopsy of the cervix should be performed or treated as stage Ib1 cervical cancer. (4) For stage Ia1 cervical cancer with lymphovascular space involvement and stage Ia2 cervical cancer, pelvic lymph node dissection should be performed at the same time, and if it is accompanied by vaginal intraepithelial neoplasia, part of the affected vagina should be removed. 2. Wide cervical resection: Wide cervical resection (radical trachelectomy) can be performed through vaginal, open and laparoscopic procedures, and its biggest advantage is that it can treat cervical cancer and preserve patients’ fertility at the same time. Indications of radical trachelectomy: (1) young patients who desire to have children; (2) patients do not have infertility factors; (3) tumor ≤2 cm; (4) clinical stage Ⅰa2～Ⅰb1; (5) squamous carcinoma or adenocarcinoma; (6) colposcopy does not find tumor infiltration over the internal os of the uterine cervix; (7) no metastasis of regional lymph nodes is found. Precautions: (1) Define the pathologic diagnosis and clinical staging of uterine cervical cancer before surgery, conduct accurate assessment, and strictly grasp the indications for surgery. (2) Wide excision of the cervix is only suitable for early stage cervical cancer, while patients with stage Ib2 or above cervical cancer whose tumors are >2 cm and/or involve blood vessels and lymphatic vessels are prone to recurrence after surgery, and should not be subjected to wide excision of the cervix in principle. (3) It is important to determine the size of the tumor of the uterine cervix, the relationship between the tumor and the internal orifice of the uterine cervical canal and whether there is infiltration in the myometrium of the lower segment of the uterus before the operation, and MRI examination should be applied to measure and evaluate this, with an accuracy rate of 96.7%. (4) Intraoperative frozen pathologic examination should be performed routinely and its accuracy should be ensured as much as possible. The pathological findings of pelvic lymph nodes and cervical margins are of great significance in guiding the treatment of fertility preservation. (5) Follow-up of pregnancy after fertility preservation surgery. Postoperative follow-up: patients should be followed up monthly in the first six months after surgery, including gynecological examination, ultrasound examination and serum squamous epithelial cell carcinoma antigen (SCC-Ag) level detection, and CT, MRI and positron emission tomography (PET)-CT examination if necessary. If there were no abnormalities, follow-up visits were made every 2 months thereafter; every 3 months after 1 year; and every 6 months after 3 years. Cervical cytology was performed every 3 months, and if both cytologies were negative, the patient could be advised to become pregnant. Most scholars suggest that pregnancy can be achieved after 6 months postoperatively, and if natural conception fails, assisted reproductive technology can be considered. 3. Ovarian preservation problem: The ovarian metastasis rate of early stage cervical cancer is very low, among which the ovarian metastasis rate of squamous carcinoma of the cervix is <1%, and that of adenocarcinoma of the cervix is about 10%. Clinical data also show that there is no clear relationship between sex hormones secreted by the ovaries and the development of squamous cervical cancer. Therefore, patients with early squamous carcinoma of the uterine cervix can routinely have both ovaries preserved intraoperatively, while patients with early adenocarcinoma of the uterine cervix routinely have both ovaries removed. Indications for preserving ovaries: (1) pathological type of squamous carcinoma of the uterine cervix; (2) patient's age ≤45 years old; (3) tumor ≤2 cm; (4) no tumor infiltration of the uterine corpus and paracervical tissues; and (5) no clear lymph node metastasis. For patients with cervical cancer who need pelvic radiotherapy. The ovaries can be surgically (open or laparoscopic) relocated to a site outside the pelvic radiation field prior to radiotherapy. It is often fixed in the lateral colonic sulcus, below the transverse colon, in order to preserve the endocrine function of the ovary and to help improve the quality of life of the patient after treatment. Biopsy and rapid frozen pathological examination of both ovaries should be performed and no tumor metastasis should be confirmed before ovarian translocation. (II) Endometrial cancer With the changes of women's life style and diet structure in China, the incidence of endometrial cancer is on the rise. For young endometrial cancer patients, treatment with high-dose high-efficiency progesterone to preserve reproductive function has been proved to be an effective treatment option. 1. Indications: (1) patients ≤40 years old; (2) strong fertility requirements; (3) pathologic type of endometrioid adenocarcinoma; (4) high differentiation; (5) lesions confined to the endometrium, with no myometrial infiltration, extrauterine spread or lymph node involvement; (6) positive PR expression (for those who are applicable to progesterone therapy); (7) no contraindications to progesterone therapy for those who are applicable to progesterone therapy; and (8) no contraindication to progesterone therapy for those who are applicable to progesterone therapy. (7) The patient has no contraindications to progestin therapy (for those who are eligible for progestin therapy); (8) The patient is well-informed and able to comply with treatment and follow-up. 2. Pre-treatment evaluation: (1) Medical history taking: detailed inquiries about menstruation, marriage and childbearing history; previous treatment and treatment response; history of complications, such as polycystic ovary syndrome (PCOS), infertility, diabetes mellitus, hyperlipidemia and so on. (2) Physical examination and assessment of general condition: including height, body mass, body mass index (BMI), etc.; gynecological examination; normal complete blood count; normal liver and renal function; normal coagulation function; normal electrocardiogram; chest radiographs, except for lung metastasis, hydrothorax, tuberculosis and lung cancer. (3) Pathological diagnosis review: review by senior gynecologic pathologist, with the pathology type of endometrioid adenocarcinoma, the degree of pathological differentiation of high differentiation, and positive immunohistochemical staining PR. (4) Assessment of disease extent: ① no myometrial infiltration: transvaginal ultrasound (TVUS) or pelvic MRI; ② no concomitant ovarian malignancy: serum CA125 level test and TVUS, and laparoscopy and biopsy, if necessary; ③ no pelvic lymph node involvement: pelvic CT, MRI, and PET-CT or laparoscopy and biopsy, if necessary. Informed consent: explain in detail to patients the advantages and disadvantages of surgical treatment and drug conservative treatment; explain the process of fertility preservation treatment, drug side effects and the risk of disease progression; make sure that patients are fully aware of the treatment process and risks, and are able to insist on completing the treatment and follow up; and give the patients sufficient time for consideration and counseling, and start the treatment after they have voluntarily chosen the conservative treatment and signed the informed consent form for the treatment. 3. Treatment: (1) high-dose high-efficiency progestin treatment: ① Drug choice: megestrol tablets, continuous oral, 250-500 m/d; or megestrol tablets, continuous oral, 160-480 m/d. (2) Dosage adjustment: the dose can be increased or decreased during the treatment period according to the presence or absence of vaginal bleeding and the change of the endometrial thickness in the above dosage range. (2) Other therapeutic methods: for patients with contraindications to progesterone therapy such as obesity and liver function abnormalities, rarely used alone, most often used in combination of two methods. ① gonadotropin-releasing hormone agonist (GnRH-a); ② levonorgestrel intrauterine sustained-release system (LNG-IUS); ③ aromatase inhibitors, such as letrozole. (3) Systemic comprehensive treatment of comorbidities: ① weight loss, lipid reduction: knowledge education, diet control, exercise guidance; ② diagnosis and treatment of diabetes mellitus. 4. Monitoring of side effects: (1) Possible side effects: increased body mass, irregular vaginal bleeding, breast distension, decreased appetite, nausea and vomiting, skin rash, thromboembolic disease. (2) Methods of monitoring: Observation of the above symptoms, monthly measurement of body mass, measurement of liver and kidney functions, measurement of endometrial thickness by transvaginal ultrasonography, observation of ovarian size. 5. Assessment of efficacy: (1) Timing and method of assessment: 3 months of continuous drug treatment as a course of treatment; routine ultrasound and/or MRI examination every 3 months to assess the size of the uterus, the thickness of the endometrium, and the presence of myometrial infiltration, and to understand the condition of the pelvic and abdominal cavity and other organs such as ovaries; hysteroscopy or diagnostic scraping to obtain the endometrial tissues to be sent to the pathologist for examination. (2) Criteria for determining the efficacy: ① complete remission: complete regression of endometrium after treatment, interstitial metaplasia, without any endometrial hyperplasia or cancerous foci; ② partial remission: endometrial lesions of lower grade or residual cancerous foci, accompanied by gland degeneration and atrophy; ③ no response or stable condition: no change in endometrium after treatment, residual cancerous foci, endometrium with no degradation and atrophy; ④ disease progression: endometrial cancer patients with clear myometrial infiltration; endometrial cancer patients with clear myometrial infiltration; endometrial cancer patients with clear myometrial infiltration. (iv) Disease progression: endometrial cancer patients develop clear myometrial infiltration or extra-uterine lesions. 6. Indications for termination of drug therapy: drug therapy can be terminated if any of the following conditions are met. (1) There is definite evidence of myometrial infiltration or extra-uterine lesions, i.e. disease progression. (2) The patient no longer requires preservation of reproductive function. (3) Efficacy assessment has reached complete remission (stop treatment or consolidation therapy for 1 course of treatment, as appropriate). (4) Serious side effects have occurred and treatment cannot be continued. (5) Continuous treatment for 6 months, but the tumor does not respond. 7. Follow-up and subsequent treatment: (1) Those who do not have reproductive requirements for the time being: the purpose of treatment is to maintain regular menstruation and prevent recurrence. ①Treatment targets: those who have completed high-dose progesterone treatment and obtained complete remission; those who are unmarried or divorced; and those who have completed childbearing. ②Treatment: If you have natural menstruation, observe and measure your basal body temperature. If there is no natural menstruation or basal body temperature monitoring suggests anovulation, give oral progestin ≥12 d/month, followed by withdrawal bleeding; or oral short-acting contraceptive pills, with regular withdrawal bleeding every month; or intrauterine implantation of LNG-IUS; for those who have already had a child, give intrauterine implantation of LNG-IUS or surgical resection of the uterus. (3) Condition monitoring: regular follow-up every 3-6 months, recording menstruation, pelvic ultrasound to detect endometrial condition, if there is abnormal thickening of endometrium or space-occupying lesion, irregular vaginal bleeding, perform diagnostic scraping to find out the condition of endometrium. (2) Those who urgently want to have children: the purpose of treatment is to monitor ovulation and actively assist pregnancy. (1) Previous history of infertility: perform infertility examination, including semen routine, uterine iodine oil imaging and the presence of ovulation disorders, etc. If any abnormality is found, the patient should be treated individually according to the cause and degree of infertility. If any abnormality is found, individualized treatment will be carried out according to the cause and degree of infertility: if no abnormality is found, ovulation will be monitored, pregnancy will be expected, and those who are still infertile will be assisted in pregnancy by assisted reproductive technology. ②No previous history of infertility: observe the recovery of menstruation in natural cycle, monitor basal body temperature to know the ovulation situation, and try to get pregnant naturally by intercourse during ovulation period; if it is found that there is no ovulation or there is ovulation but there is no natural pregnancy in 6 months, then it will enter into the above infertility checkups and treatment process. (iii) Condition monitoring: the method is the same as before. (iii) Ovarian malignant tumor Ovarian malignant tumor is a category of gynecological malignant tumors with the highest morbidity and mortality rate. Different pathological types of ovarian malignant tumors have different clinical manifestations, and the treatment and prognosis are not the same. The feasibility of surgical treatment for ovarian malignant tumors with preservation of fertility depends on the patient's age, pathological type and surgical pathological staging. 1. Ovarian epithelial cancer: patients with ovarian epithelial cancer (ovarian cancer) should be cautious about fertility preservation treatment, and they should be strictly selected, patients and their families should be informed of the advantages and disadvantages as well as the risks of fertility preservation treatment, and their understanding and agreement should be sought and a consent form for treatment should be signed. Surgery for preserving fertility function of ovarian cancer can only be performed under the following conditions: (1) the patient's age is <35 years old and desires to have children; (2) the surgical pathological staging is stage A; (3) the degree of pathological differentiation is highly differentiated; (4) the contralateral ovary is normal in appearance and the pathological examination is negative after biopsy; (5) the abdominal cytological examination is negative; and (6) "high-risk areas " (including uterorectal pit, lateral colonic sulcus, mesentery, greater omentum and retroperitoneal lymph nodes) exploration and multipoint biopsy are negative; (7) there are conditions for followup; (8) uterine and contralateral adnexal resection will be performed again after completion of childbearing, as appropriate. 2. Malignant germ cell tumors of the ovary: (1) Surgery for fertility preservation: as a basic principle in the treatment of malignant germ cell tumors of the ovary, it is not limited by the stage. Rationale: most ovarian malignant germ cell tumors are unilateral; recurrence is seldom in the contralateral ovary and uterus; they are sensitive to cisplatin + etoposide + bleomycin (PEB), cisplatin + vincristine + bleomycin (PVB) regimen; resection of contralateral ovary and uterus doesn't improve the patient's prognosis. (2) Surgical scope: adnexectomy on the affected side, preserving the contralateral normal ovary and uninvolved uterus, removing the metastatic lesions as cleanly as possible, and supplemented with postoperative chemotherapy, with attention to the toxic effects of chemotherapy on the ovaries and ovarian protection. For early stage ovarian anaplastic cell tumor and grade I immature teratoma, in addition to adnexectomy of the affected side, comprehensive staging surgery including salpingo-oophorectomy and retroperitoneal lymph node dissection should be carried out. If the surgical pathological stage is confirmed to be stage Ia1, chemotherapy can be withheld after surgery. 3. Ovarian junctional tumor: (1) Unilateral ovarian junctional tumor: for young patients <40 years old, usually perform adnexectomy on the affected side to preserve the reproductive function. Staging surgery is not recommended for early-stage patients, because too large a surgical scope can cause pelvic adhesions, leading to postoperative infertility; and early-stage patients need little postoperative chemotherapy. (2) Bilateral ovarian junctional tumor: its incidence is 38%, as long as there is normal ovarian tissue present, only tumor excision can be performed to preserve fertility. (3) Late-stage ovarian junctional tumors: as long as the contralateral ovary and uterus are not involved. In the absence of exophytic papillary structures and infiltrative implantation, fertility preserving treatment can also be considered. Since most patients with ovarian junctional tumors are young, they are prone to recurrence after surgery and are tricky to manage. Therefore, the pros and cons and risks of fertility preservation treatment must be explained to the patients and their families before treatment to gain their understanding and consent, and sign a treatment consent form. (D) Gestational trophoblastic tumors It is a clinical consensus that fertility preservation treatment for gestational trophoblastic tumors is based on the following principles: (1) Trophoblastic tumors mainly occur in women of childbearing age, and the treatment is mainly based on chemotherapy. (2) Preservation of fertility is a basic principle in the treatment of trophoblastic tumors. (3) For patients with advanced trophoblastic tumors with distant metastases, including neurological metastases, as long as the treatment results are satisfactory, their reproductive function can be preserved. (4) The incidence of abortion, fetal malformation and obstetric complications caused by chemotherapy in patients with trophoblastic tumors is not significantly higher, and the rate of chromosomal aberrations in newborns born to cured patients with long-term follow-up is not significantly different from that of normal population. Second, gynecologic malignant tumors to preserve fertility-related reproductive endocrine therapy This part of the treatment should be reproductive endocrinology experts, however, gynecologic oncologists should be involved in the development of treatment plans and patient follow-up. Although the perception of the risk of permanent amenorrhea after radiation and chemotherapy has not changed much in recent years, evolving and refined techniques for fertility-preserving treatments may play a decisive role in formulating clinical decisions for patients. Reproductive endocrine therapies associated with the preservation of fertility function in gynecologic malignancies include embryo cryopreservation, oocyte cryopreservation, ovarian suppression, and ovarian tissue cryopreservation and transplantation. Options for preserving fertility depend on the patient's age, pathologic diagnosis, treatment, whether or not the patient is married, and the wishes of the individual patient and family. Because some reproductive endocrine treatment options may delay tumor treatment, early referral to a gynecologic oncologist should be emphasized to minimize the risk of delayed tumor treatment. 1. Embryo cryopreservation: Embryo cryopreservation is the most mature and successful method of preserving reproductive function. Cryopreservation of embryos remaining after in vitro fertilization has long been routinely used in clinical practice with high success rates. Although day 3 of the menstrual cycle is the ideal time for pharmacologic stimulation of the ovaries, recent studies have found that stimulation of the ovaries at any time of the menstrual cycle can be successful. In addition, letrozole or tamoxifen are equally effective compared to conventional drugs and should be the drug of choice for ovarian stimulation in patients with hormone-sensitive tumors. Aromatase inhibitors (e.g., letrozole) are primarily used in the adjuvant treatment of hormone-sensitive breast cancer (premenopausal women) and have the ability to both stimulate the ovaries and suppress estrogen levels. As a result, letrozole has been used within the last 10 years for ovulation induction in infertile patients, as well as for ovarian stimulation in patients with hormone-sensitive tumors in preparation for oocyte or embryo cryopreservation (note: reproductive use of letrozole is an over-the-counter indication for use and is limited to clinical studies). In combination with conventional drugs, letrozole increases ovarian stimulation and maintains estrogen at relatively low levels. The procedure involves ovarian stimulation and egg retrieval prior to chemotherapy or surgery, processing of oocytes and sperm followed by conventional in vitro fertilization or intracytoplasmic monosperm injection of oocytes, in vitro culturing of the fertilized eggs and embryos to evaluate their development, and freezing of the well-developed embryos for storage and embryo transfer after completion of chemotherapy. Studies have shown that this route results in similar numbers of oocytes, embryos, and pregnancy outcomes as conventional therapy. Short-term follow-up studies have shown no significant effect on the patient's tumor-free survival time. 2. Oocyte cryopreservation: Oocyte cryopreservation is also one of the treatment options available, especially for unmarried (including pre-pubertal) patients who do not want to use donor sperm, who are temporarily unwilling to use their husband's sperm, or who have religious ethical considerations regarding embryo freezing. Previously, oocyte cryopreservation was only clinically tested in treatment centers with relevant experience and was divided into immature oocyte cryopreservation and mature oocyte cryopreservation. The immature oocyte in vitro maturation technique can be used in patients who are unsuitable or unwilling to undergo hormonal pharmacologic stimulation, either by ultrasound-guided puncture to obtain immature oocytes at any time during the menstrual cycle or by searching for immature oocytes during thin sectioning of ovarian tissues for freezing, culturing and maturing in vitro, and then freezing and preserving them. And the mature oocyte cryopreservation technique has been available since October 2012 as its success rate has significantly improved. The American Society for Reproductive Medicine (ASRM) believes that the technology is no longer limited to the clinical trial stage. Some assisted reproduction research centers have reported success rates for mature oocyte cryopreservation that are comparable to those of fresh oocyte technology, especially in younger women. Mature oocyte cryopreservation requires pharmacological stimulation of the ovaries and ultrasound-guided egg retrieval, and there are currently a wide range of ovarian stimulation regimens available. Stimulation can begin at any time depending on follicular status and is no longer dependent on the menstrual cycle, i.e., the acquisition of oocytes can be non-menstrual cycle-dependent, and ovarian stimulation can be initiated as early as possible in comparison with traditional stimulation regimens to shorten delayed oncologic treatment. Oocyte cryopreservation is significant for unmarried women who do not want to use donor sperm.1 A meta-analysis showed a 21% live birth rate using this method. Recent studies have shown that the probability of congenital anomalies in newborns obtained using oocyte cryopreservation is similar to that of natural pregnancies or pregnancies with fresh oocytes, but further research is needed on the damage to oocytes caused by low temperatures, and on the toxic effects of cryoprotectants. In addition, China's current regulations on assisted reproduction do not clarify the use of unmarried women's oocytes for assisted reproduction techniques, and further improvement of the relevant regulations is needed to meet the needs of social development. 3. Ovarian displacement: Ovarian displacement can be considered when tumor treatment involves pelvic radiotherapy. However, due to radiation scattering and reduced blood supply to the displaced ovary, the function of the displaced ovary may not always be well protected, and patients should realize that this treatment option may not always be effective. In addition, repositioning of the displaced ovary may occur, so this technique should be performed as close to the start of radiotherapy as possible. The endocrine function of the ovaries should be checked regularly after ovarian translocation. 4. Ovarian suppression: Currently, there is a lack of validated evidence to support the exact efficacy and clinical value of GnRH-a and other means of ovarian suppression in fertility preservation therapy. There is still much controversy about whether GnRH-a is effective in protecting ovarian function. Patients should be encouraged to actively participate in clinical trials related to the use of GnRH-a during chemotherapy to further clarify its clinical value. 5. Ovarian tissue cryopreservation and transplantation: Ovarian tissue is cryopreserved before treatment in women of childbearing age, and the frozen ovarian tissue is transplanted into the patient after completion of tumor treatment and before preparation for childbearing. This technique is not dependent on ovarian stimulation or sexual maturation, and is therefore the only option for pediatric patients. This technique is still considered to be in clinical trials and can only be performed in research centers with relevant experience, subject to ethical committee review, and with follow-up for tumor recurrence. To date, more than 19 live births have been reported. Whether the transplanted ovarian tissue will reintroduce tumor cells remains the biggest concern and the most feared issue with this technique, depending mainly on the primary site of the tumor, the type of pathology and the surgical pathology staging, and no tumor recurrence has been reported. Therefore, cryopreservation of human ovarian tissue must be carried out under strict control of its indications for use. 6. Treatment of estrogen-sensitive tumors: The biggest concern for estrogen-sensitive gynecologic malignancies is whether interventions that preserve fertility (e.g., ovarian stimulation by increasing exogenous estrogen) and/or subsequent pregnancy increase the risk of tumor recurrence. Ovarian stimulation regimens using aromatase inhibitors (e.g., letrozole) may reduce this concern, and some studies have shown that pregnancies obtained with this regimen do not increase the risk of tumor recurrence. 7. Other considerations: (1) BRCA gene mutation carriers, especially those with the BRCA1 gene mutation, have lower reserve function of the ovaries, respond poorly to ovulation induction, and are more susceptible to chemotherapy-induced infertility. These gynecological malignant tumor patients should be given great importance when consulting the question of "whether chemotherapy causes infertility". (2) For patients with familial hereditary tumors, the use of oocyte or embryo cryopreservation may be more beneficial, because embryo biopsy can detect the corresponding gene mutations, and pre-transplantation genetic diagnosis can also provide important clues and evidence. (3) An oncofertility (oncofertility) expert group should be formed, including experts in gynecologic oncology, radiotherapy, pathology, gynecologic endocrinology and reproductive medicine, to jointly formulate a diagnosis and treatment plan, which should be based on the patient's anatomical location of the tumor, pathological type, staging, reproductive status, lifestyle, risk of infertility after treatment, and probability of recurrence of the tumor, etc., and should be integrated to formulate an individualized Treatment plan.