Fertility Following Fertility-Sparing Surgery for Borderline Ovarian Tumors

Area of Science:

• Gynecology
• Reproductive Medicine
• Oncology

Background:

• Borderline ovarian tumors (BOTs) frequently affect women of reproductive age.
• Surgical management of BOTs raises significant concerns regarding fertility preservation.
• Infertility may be linked to BOT development, impacting reproductive fitness.

Purpose of the Study:

• To review fertility-sparing surgery (FSS) and fertility preservation (FP) strategies for young women with BOTs.
• To evaluate the oncological safety and reproductive outcomes associated with FSS in BOT patients.
• To provide insights into current guidelines and controversial aspects like ovarian stimulation.

Main Methods:

• Literature review of studies on FSS, FP, and BOT management.
• Analysis of recurrence risk, survival rates, and pregnancy outcomes post-FSS.
• Examination of the association between ovarian stimulation and BOT risk.

Main Results:

• FSS shows a slightly increased recurrence risk but maintains 10-year overall survival.
• Recent guidelines advocate for FSS in all stages of BOT.
• Ovarian stimulation's link to BOT risk is inconclusive; however, it's a viable option for recurrent stage I BOT.
• Past BOT history does not significantly impact IVF pregnancy outcomes.

Conclusions:

• FSS is a safe and recommended approach for BOT, balancing oncological control and fertility preservation.
• FP counseling is crucial for personalized treatment plans in BOT patients undergoing FSS.
• Further research is needed to clarify the BOT-ovarian stimulation relationship.