Clinical recommendation on fertility preservation in borderline ovarian neoplasm: ovarian stimulation and oocyte retrieval after conservative surgery.
OBJECTIVE
To evaluate safety and fertility outcome after assisted conception in patients who were treated conservatively for a borderline ovarian tumor (BOT).


METHODS
A systematic literature review using Medline was conducted. From all the relevant case series the following information was obtained for each reported patient: primary diagnosis; disease stage; surgical treatment; duration of follow-up; incidence of recurrence; current disease status; the number of controlled ovarian stimulation cycles and/or oocyte retrievals, and successful pregnancies.


RESULTS
Overall 588 articles were screened, of which finally 15 reports including 62 patients met the inclusion criteria. Within a median follow-up duration of 52 months in this small group of patients, overall 12 patients (19.4%) had recurrences, and those recurrences were again successfully treated by surgery in 11 patients. In terms of assisted reproductive outcome, in our series overall 152 ovarian stimulation cycles as well as 135 oocyte retrievals were performed with a baby-take-home rate of 28.3% per stimulated cycle.


CONCLUSIONS
It is mandatory to counsel all patients with a history of BOT who are seeking treatment for infertility that, due to the limited data, it is unclear whether assisted reproductive techniques are associated with an increased risk of recurrence.
Denschlag
Dominik
D
Task Force Fertility Preservation, European Society of Gynecologic Oncology, European Society of Human Reproduction and Embryology, and Department of Obstetrics and Gynecology, University of Freiburg School of Medicine, Freiburg, Germany. dominik.denschlag @ uniklinik-freiburg.de
von Wolff
Michael
M
Amant
Frederic
F
Kesic
Vesna
V
Reed
Nicholas
N
Schneider
Achim
A
Rodolakis
Alexandros
A
D003376:Counseling; D005260:Female; D005298:Fertility; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000150:complications*; D009367:Neoplasm Staging; D054315:Oocyte Retrieval / Q000009:adverse effects*; D010051:Ovarian Neoplasms / Q000150:complications* / Q000601:surgery*; D010062:Ovulation Induction / Q000009:adverse effects*; D012306:Risk