Fertility and tumor recurrence rate after conservative laparoscopic management of young women with early-stage borderline ovarian tumors

Abstract

Objective: To evaluate the efficacy of laparoscopic conservative surgery in young women with borderline ovarian tumors who want to preserve their childbearing potential, and to assess whether pregnancy influences the recurrence rate during the follow-up evaluation period. Design: Retrospective study. Setting: Center for Reconstructive Pelvic Endosurgery, Reproductive Medicine Unit, S. Orsola Hospital, University of Bologna, Italy. Patient(s): Nineteen women (mean age 27.4 ± 4.7) with borderline ovarian tumors who underwent laparoscopy between January 1995 and January 1998. All of the women wanted to preserve their fertility. Intervention(s): A standardized conservative laparoscopic approach and a strict follow-up schedule. Main Outcome Measure(s): A complete preoperative examination. Result(s): Follow-up evaluations (mean 42 ± 19 months) were made available to all patients. Among 19 patients, 10 attempted pregnancy and 6 conceived spontaneously. All six pregnancies went to term and the disease did not affect the gestation or the follow-up period after the pregnancy (24.5 ± 15.7 months). Conclusion(s): Conservative laparoscopic management of borderline ovarian tumors is a potentially safe alternative in young women who want to retain their childbearing potential. Fertility and pregnancy outcome remain excellent in these women. Our preliminary data seem to indicate that the recurrence rate after pregnancy is not influenced by this approach.