Fertility preservation in rare ovarian malignancies: a decade-spanning systematic review of menstrual and reproductive outcomes.
AI interpretation is pending for this paper.
Open original publication →What the AI sees
Not AI summarized yet.
Research significance
Pending deeper interpretation.
Source abstract
PURPOSE: Fertility preservation is a growing priority in the management of young women with rare ovarian tumors, including malignant ovarian germ cell tumors (MOGCTs), sex cord-stromal tumors (SCSTs), and borderline ovarian tumors (BOTs). These malignancies often affect adolescents and women of reproductive age and are frequently treated with fertility-sparing surgery and platinum-based chemotherapy. Our objective is to systematically evaluate reproductive outcomes, menstrual function recovery, and fertility preservation strategies in female survivors of rare cancers such as MOGCTs, SCSTs, and BOTs. METHODS: A systematic review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. PubMed, Scopus, and BioMed Central were searched for studies published between 2005 and 2025. Eligible studies included observational or cohort designs reporting on fertility status, menstrual recovery, and reproductive outcomes following treatment for rare tumors. A total of 24 studies met the inclusion criteria. Data extraction included fertility preservation approaches, rates of natural versus assisted conception, menstrual function outcomes, and the incidence of premature ovarian insufficiency (POI). RESULTS: Fertility-sparing surgery with or without chemotherapy was the most applied fertility preservation strategy. Spontaneous conception was predominant, with pregnancy rates ranging from 50% to over 90%. Menstrual recovery occurred in 71-100% of patients. POI was rare in solid tumor survivors but occurred in up to 87% of leukemia patients. Long-term follow-up showed durable ovarian function and no increase in cancer recurrence. Ovarian tissue cryopreservation (OTC) and oocyte retrieval were effective in selected high-risk cases. CONCLUSION: Fertility preservation in patients with rare ovarian malignancies is both safe and effective. Early fertility counseling and individualized, risk-adapted strategies should be integrated into standard cancer care, especially for patients at high risk for gonadal failure.