Fertility after conservative treatment for borderline ovarian tumors:: a French multicenter study

Objective: To examine fertility outcomes and determinants of fertility after conservative surgery for women with borderline ovarian tumors. Design: Retrospective multicenter study. Setting: Thirteen specialized gynecologic units and one cancer center. Patient(s): In a study of women with borderline ovarian tumors, 162 of 360 women underwent conservative surgery; from these 162, we compared epidemiologic, surgical, and histological parameters between 21 women who conceived and 44 women who failed to conceive. Intervention(s): Conservative surgery for borderline ovarian tumors. Main Outcome Measure(s): Fertility results and outcome. Result(s): Women undergoing conservative treatment were significantly younger and more likely to be nulliparous. Tumor size was significantly smaller in the conservative treatment group. Thirty pregnancies occurred in 21 (32.3%) of the 65 women who wished to conceive after conservative treatment. Twenty-seven pregnancies were spontaneous, whereas three occurred after ovarian stimulation and IUI (one case) or IVF (2 cases). Women who conceived did not differ from women who did not conceive in terms of the tumor recurrence rate or the mean time to recurrence (39.6 +/- 28.2 and 22.9 +/- 14.9 months, respectively). Age at initial treatment was the only determinant of fertility. Conclusion(s): Despite a high recurrence rate, our results confirm that conservative surgery for women with borderline ovarian tumors is an acceptable option and that fertility is preserved in nearly one third of cases.