FERTILITY AFTER CONSERVATIVE TREATMENT OF OVARIAN IMMATURE TERATOMAS

The objective of this study was to assess the reproductive experience of patients with immature teratomas who underwent fertility preserving therapy. Thirty-five consecutive patients with immature teratoma of t he ovary treated, or consulted on, by the Yale Gynecologic Oncology Se rvice over a 20-year period were assessed. Charts were reviewed retros pectively and when necessary, follow-up information was obtained by te lephone calls to patients or their referring physicians. All 35 patien ts underwent surgery. Thirty-four (97%) patients received chemotherapy according to protocols current at the time of their treatment. One pa tient (2.8%) had an ovarian cystectomy only with no further adjuvant t herapy. Twenty-three patients (65.7%) had fertility preserving treatme nt. Of these patients, two have not yet completed their sexual develop ment and one underwent bilateral tubal ligation immediately after comp letion of her chemotherapy as she had fulfilled her reproductive goals prior to her diagnosis. Of the remaining 20 patients, 10 (50%) had un dergone wedge biopsy of the contralateral ovary. This information was not available iii an additional two patients. Of the 13 patients attem pting pregnancy, 11 have been successful. Eight of these patients had stage I and three had stage III disease. Twenty-six conceptions have o ccurred. Of these, five have culminated in elective and two in spontan eous abortions while the other 19 have led to the delivery of 19 healt hy infants. Two patients (8.7%) have experienced infertility, one due to pelvic inflammatory disease and the other due to postoperative adhe sions. Both of these patients had stage I disease. Fertility preservin g treatment is appropriate for all patients with immature teratomas of the ovary who wish to maintain their reproductive function.