Table 2 Fertility-sparing interventions in women with borderline ovarian tumors or ovarian cancer

Borderline Ovarian Tumor FIGO Stage Ia

Unilateral oophorectomy/bilateral cystectomy

Removing the affected ovary only, keeping in place the unaffected one and the uterus

Spontaneous pregnancies have been reported with favorable obstetric outcome [99]

Higher recurrence rates in fertility-sparing surgery compared with radical surgery, with no difference in mortality [97, 98]. Recurrence 0 %–20 % versus 12 %–58 % when only cystectomy was performed [6]

High quality of life and higher sexual satisfaction scores after fertility-sparing surgery [103]

Borderline Ovarian Tumor FIGO Stages Ic–III

Unilateral oophorectomy/bilateral cystectomy, peritoneal staging, pelvic & para-aortic lymphadenectomy, omentectomy

Removing the affected ovary only, thorough oncological staging

Pregnancy rate of 86 %, more than half of the patients required fertility treatment [99]

No difference in recurrence or survival compared with radical surgery removing both ovaries and the uterus [6, 99].

Lack of data

Ovarian Epithelial Cancer FIGO Stage IA, grade 1

Unilateral oophorectomy, peritoneal staging, pelvic & para-aortic lymphadenectomy and omentectomy

Removing the affected ovary only, thorough oncological staging

Pregnancy rates of >60 % Pregnancies have been reported with favorable obstetric outcome [145]

5-year survival 87 %, recurrence 7–12 % [6, 17]

No difference in quality of life aspects or sexual satisfaction scores compared with radical surgery [46]

Ovarian Epithelial Cancer – FIGO Stage IA, grade 2–3 or Clear Cell Carcinoma

Unilateral oophorectomy, peritoneal staging, pelvic & para-aortic lymphadenectomy, omentectomy and adjuvant chemotherapy

Removing the affected ovary only, thorough oncological staging

Adjuvant platinum-based chemotherapy

Pregnancy rate of 80 % with live-birth rate of 65 % in women presenting with cancer grades 1–3. Higher number of women with cancer grades 1–2 attempting pregnancy in comparison with women with grade 3 cancers [87]

No difference in recurrence or survival compared with radical surgery [86]

Lack of data

Malignant Germ Cell Cancers grade I

Unilateral oophorectomy, peritoneal staging, omentectomy, pelvic & para-aortic lymphadenectomy and adjuvant chemotherapy

Removing the affected ovary only, adjuvant BEP chemotherapy has been recommended, or expectant management

76 % pregnancy rate. Pregnancies have been reported with favorable obstetric outcome [147, 148]

Fertility-sparing surgery has not been associated with impaired oncological outcome [108]

Good quality of life reported with good psychological health and sexual function [129]