Abstract
Borderline ovarian tumors (BOTs) represent around 15% of all epithelial ovarian cancer. Around one third of those patients is under 40 and has not completed childbearing when the tumor is diagnosed. Cancer survivors are more and more concerned about their future fertility since a large proportion of those with BOTs are young. Whatever the tumor stage, information regarding future fertility after treatment and fertility preservation (FP) options must be delivered to all patients before treatment. A multidisciplinary team will discuss and propose personalized treatment and FP strategies. Nowadays, the FP options offered to patients with BOT are the followings: i) minimal invasive conservative surgery, ii) oocyte cryopreservation after controlled ovarian stimulation (COS) or in vitro maturation (IVM) and iii) ovarian tissue cryopreservation. Generally, the most common strategy to preserve future fertility is represented by minimal invasive conservative surgery. However, with the remarkable success and evolution of assisted reproductive technologies (ART) – notably progress and efficiency in COS and oocyte vitrification – have led to offer another potential approach for FP consisting in oocyte cryopreservation. Several COS protocols, such as random start or dual stimulation associating tamoxifen or aromatase inhibitors with gonadotropins provide similar results when compared to standard protocols while providing safety by minimizing the risk of high estrogen exposure. When COS is contraindicated, oocyte cryopreservation can still be possible throw IVM. Even though, oocyte competence after IVM is lower than that obtained after COS. A less used approach is cryopreservation of ovarian tissue, consisting in freezing ovarian cortex fragments for a future thawing and graft. Some concerns and limitations regard the ovarian cortex graft and the risk of reintroducing malignant cells once performed. Nonetheless, the latter it is the only option in prepubertal patients.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission
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Competing interests: Authors have no conflict of interest
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Informed consent: Not applicable.
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Ethical approval: Not applicable.
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© 2020 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Special Issue 1: Adenomyosis and Endometriosis: An Update; Edited by René Druckmann and Adolf E. Schindler
- Review Articles
- The impact of endometriosis on the outcome of assisted reproductive techniques: role of fertility preservation
- A narrative review of functional outcomes following nerve-sparing surgery for deeply infiltrating endometriosis
- Appropriate surgical management of ovarian endometrioma: excision or drainage?
- Diaphragmatic endometriosis and thoracic endometriosis syndrome: a review on diagnosis and treatment
- Rates of anastomotic leak and fistula following surgical management of bowel endometriosis: a comparison of shaving, discoid excision, and segmental resection
- Endometriosis at all ages: diagnostic ultrasound
- Special Issue 2: Fertility Preservation in Cancer Patients and Survivors; Edited by René Druckmann and Adolf E. Schindler
- Opinion Paper
- Quality of life and sexual dysfunction in gynaecological cancer patients: a psychosomatic approach
- Review Articles
- Fertility preservation in women with early ovarian cancer
- Fertility in BRCA mutation carriers: counseling BRCA-mutated patients on reproductive issues
- Fertility preservation in borderline ovarian tumor patients and survivors
- Regular Issue
- Original Articles
- Effects of iron-related compounds and bilirubin on redox homeostasis in endometriosis and its malignant transformations
- miR-515-3p, miR-623, miR-1272 and Notch3 protein as new biomarkers of Hepatocellular carcinoma
- Combination therapy of calcitriol inhibits the proliferation of breast cancer cells: new concept of nonclassical function of calcitriol
- The change pattern in serum G protein-coupled estrogen receptor-1 (GPER1) levels during pregnancy with and without gestational diabetes mellitus
- Effects of Helichrysum Psudoplicatum supplementation on pruritus intensity, fatigue, quality of life and anorexia in hemodialysis patients: a randomized, double-blind placebo-controlled trial
- The anticancer and free radical scavenging potential of the Unani medicine Agaricus albus L.
- Review Articles
- What is the optimal luteal support in assisted reproductive technology?
- The relation between obesity, kisspeptin, leptin, and male fertility
Artikel in diesem Heft
- Frontmatter
- Special Issue 1: Adenomyosis and Endometriosis: An Update; Edited by René Druckmann and Adolf E. Schindler
- Review Articles
- The impact of endometriosis on the outcome of assisted reproductive techniques: role of fertility preservation
- A narrative review of functional outcomes following nerve-sparing surgery for deeply infiltrating endometriosis
- Appropriate surgical management of ovarian endometrioma: excision or drainage?
- Diaphragmatic endometriosis and thoracic endometriosis syndrome: a review on diagnosis and treatment
- Rates of anastomotic leak and fistula following surgical management of bowel endometriosis: a comparison of shaving, discoid excision, and segmental resection
- Endometriosis at all ages: diagnostic ultrasound
- Special Issue 2: Fertility Preservation in Cancer Patients and Survivors; Edited by René Druckmann and Adolf E. Schindler
- Opinion Paper
- Quality of life and sexual dysfunction in gynaecological cancer patients: a psychosomatic approach
- Review Articles
- Fertility preservation in women with early ovarian cancer
- Fertility in BRCA mutation carriers: counseling BRCA-mutated patients on reproductive issues
- Fertility preservation in borderline ovarian tumor patients and survivors
- Regular Issue
- Original Articles
- Effects of iron-related compounds and bilirubin on redox homeostasis in endometriosis and its malignant transformations
- miR-515-3p, miR-623, miR-1272 and Notch3 protein as new biomarkers of Hepatocellular carcinoma
- Combination therapy of calcitriol inhibits the proliferation of breast cancer cells: new concept of nonclassical function of calcitriol
- The change pattern in serum G protein-coupled estrogen receptor-1 (GPER1) levels during pregnancy with and without gestational diabetes mellitus
- Effects of Helichrysum Psudoplicatum supplementation on pruritus intensity, fatigue, quality of life and anorexia in hemodialysis patients: a randomized, double-blind placebo-controlled trial
- The anticancer and free radical scavenging potential of the Unani medicine Agaricus albus L.
- Review Articles
- What is the optimal luteal support in assisted reproductive technology?
- The relation between obesity, kisspeptin, leptin, and male fertility