Fertility-preserving approach in growing teratoma syndrome with repeated ovarian surgeries

Growing teratoma syndrome (GTS) is an extremely rare complication of malignant ovarian germ cell tumours. Repeated ovarian surgeries may be required in the case of GTS, which might pose a challenge for fertility preservation and may necessitate assisted reproductive techniques. A nulligravida in her early 20s with infertility presented with bilateral benign ovarian cysts, which appeared to be benign on initial workup but were diagnosed as left immature teratoma (stage IC1) after surgical staging and histopathological examination. She underwent bilateral ovarian cystectomy followed by chemotherapy as she was keen on fertility preservation. In her mid-20s, she had a left-sided benign serous cystadenoma removed, and 2 years later, a left ovarian dermoid cyst was removed by laparoscopy, which made us diagnose GTS. Assisted reproductive technique was pursued later, leading to a successful pregnancy. A healthy male baby was delivered at 37 weeks.