How does borderline ovarian cancer affect fertility?

Updated: Mar 18, 2019
  • Author: Andrew E Green, MD; Chief Editor: Warner K Huh, MD  more...
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Given the excellent prognosis of patients with stage I disease and its occurrence in women of reproductive age, fertility-sparing surgery is of great interest.

In patients diagnosed with stage I disease who were treated with fertility-sparing surgery of any type, a higher recurrence was found in patients who had a cystectomy, with or without contralateral oophorectomy (58%), as opposed to patients treated with oophorectomy (23%). However, only half of these patients underwent complete staging. When comprehensive staging was performed, no statistical difference was found in recurrence in confirmed cases of stage I disease. Thus, fertility-sparing surgery is an acceptable option in confirmed stage I disease. This again emphasizes the need for comprehensive staging in all cases.

Of patients who attempted pregnancy after fertility-sparing operations, a 50% conception rate was achieved among 24 patients who were studied. At the endpoint of the study, 16 live births, 4 spontaneous abortions, 3 ectopic pregnancies, and 2 ongoing pregnancies were found. No fetal anomalies were reported.

All authors, nevertheless, indicate that this is an area that needs further research because, in the literature, only 48 patients were found to have conceived after having conservative surgery for borderline tumors.

In another study, which looked at 25 women who underwent fertility-sparing surgery, no recurrences took place in the study period, although the range of follow-up varied widely (4-157 mo). Of the 6 patients who attempted to become pregnant, 5 were successful, resulting in 5 live births, as well as 1 patient who underwent assisted reproductive techniques but had a miscarriage.

A separate review found 254 pregnancies in 206 patients; the investigators calculated the overall pregnancy rate at 48%, based on the published numbers of women trying to conceive.

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