Infertility treatment after conservative management of borderline ovarian tumors

BACKGROUND. Young patients with ovarian tumors of low malignant potential u sually undergo conservative surgery because of the excellent prognosis of t hese tumors. Patients wishing to conceive after diagnosis occasionally requ ire ovulation induction, but data regarding the safety of assisted reproduc tive technologies in this situation remains anecdotal. The current study an alyzes the outcome of a group of patients who received infertility treatmen t after the conservative management of borderline ovarian tumors. METHODS. The clinical and pathologic records of 104 patients with a borderl ine tumor of the ovary who were treated and followed over a 20-year period (1979/1999) were reviewed. Forty-three patients who underwent conservative management were the subjects of the current study. RESULTS. Follow-up was available for 95% of the patients, giving a total of 270 women-years of follow-up. Nine of the 43 patients developed a local re currence, 8 of which occurred in patients with serous tumors. Five of these 9 patients underwent cystectomy only at the time of recurrence, and all we re without evidence of disease at a mean follow-up of 75 months (range, 25- 93 months). Nineteen patients delivered a total of 25 healthy children afte r diagnosis of a borderline ovarian tumor; 7 of these patients were treated with in vitro fertilization (IVF) after diagnosis. Four of these patients developed a recurrence, two patients before the IVF treatment and two patie nts after the IVF treatment. The latter two patients were without evidence of disease at the time of last follow-up (15 months and 26 months, respecti vely, after the recurrence). CONCLUSIONS. The results of the current study suggest that ovulation induct ion may be considered after the diagnosis of a borderline ovarian tumor. Re currences were observed in two of seven patients, all of which remained his tologically borderline. (C) 2001 American Cancer Society.