title: Fertility Sparing Surgery for Localized Ovarian Cancers Maintains an Ability to Conceive, but is Associated With Diminished Reproductive Potential.
abstract: BACKGROUND
  Little is known about fertility outcomes after fertility sparing surgery (FSS) for localized ovarian cancers.
  
  
  METHODS
  A random sample of 783 women treated for ovarian cancer were identified from the California Cancer Registry for survey (age 18-40 years at diagnosis; diagnosed from 1993-2007). We evaluated outcomes including post-treatment amenorrhea, infertility, early menopause (age <45), and disease recurrence. Logistic regression was used to determine the probability of amenorrhea, infertility, and recurrence. Censored data methods were used to determine the probability of early menopause.
  
  
  RESULTS
  A total of 382 women replied. One hundred and sixteen and 266 completed our survey. Two hundred and forty-five reported treatment with potential to impact fertility (i.e., systemic chemotherapy ± radiation/surgery to the abdomen/pelvis). A total of 125 had disease/stage eligible for FSS and 82 (66%) underwent FSS. While many who attempted conception did conceive, 32% did not. Younger age at diagnosis was associated with higher rates of early menopause (P < 0.001) after FSS. Recurrence rates for those undergoing FSS were 8-10%, while none of the women who underwent non-FSS surgery had a recurrence.
  
  
  CONCLUSIONS
  FSS maintains an ability to conceive for most patients. However, after FSS, there may be risks of infertility, early menopause with earlier age of treatment, and increased probability of disease recurrence.
authors.affiliation: Department of OBGYN, University of California San Francisco School of Medicine, San Francisco, California.|Department of OBGYN, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Joseph
authors.initials: J
authors.lastname: Letourneau
authors.affiliation: Department of OBGYN, University of California San Francisco School of Medicine, San Francisco, California.|Department of OBGYN, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Jessica
authors.initials: J
authors.lastname: Chan
authors.affiliation: Department of OBGYN, University of California San Francisco School of Medicine, San Francisco, California.
authors.forename: Wael
authors.initials: W
authors.lastname: Salem
authors.affiliation: Department of OBGYN, University of California San Francisco School of Medicine, San Francisco, California.
authors.forename: Sai-Wing
authors.initials: SW
authors.lastname: Chan
authors.affiliation: Department of OBGYN, University of California San Francisco School of Medicine, San Francisco, California.
authors.forename: Meera
authors.initials: M
authors.lastname: Shah
authors.affiliation: Department of OBGYN, University of California San Francisco School of Medicine, San Francisco, California.|Department of OBGYN, Cornell University, Ithaca, New York.
authors.forename: Erin
authors.initials: E
authors.lastname: Ebbel
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
authors.forename: Charles
authors.initials: C
authors.lastname: McCulloch
authors.affiliation: Department of OBGYN, University of California San Francisco School of Medicine, San Francisco, California.
authors.forename: Lee-May
authors.initials: LM
authors.lastname: Chen
authors.affiliation: Department of OBGYN, University of California San Francisco School of Medicine, San Francisco, California.
authors.forename: Marcelle
authors.initials: M
authors.lastname: Cedars
authors.affiliation: Department of OBGYN, University of California San Francisco School of Medicine, San Francisco, California.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Rosen
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000517:prevention & control*; D008593:Menopause; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D055815:Young Adult
keywords: early menopause; infertility; quality of life; survivorship issues