Menstrual function and childbearing potential after fertility-sparing surgery and platinum-based chemotherapy for malignant ovarian germ cell tumours

Abstract

Malignant ovarian germ cell tumours (MOGCT) account for 5% of all ovarian malignancies. Their elevated chemosensitivity, the frequent unilaterality and the young age of patients have strongly supported the conservative surgery as the standard approach, often followed by adjuvant platinum-based chemotherapy. The risk for recurrence is not affected by the performance of conservative versus radical surgery. During chemotherapy 50% of patients become amenorrhoeic but more than 95% of them resume normal menses after treatment completion. Literature has reported several healthy babies born after fertility-sparing surgery with or without chemotherapy for MOGCT. The incidence of miscarriages is in the normal range, whereas malformation rate is slightly higher compared to general population, without any difference between chemotherapy-treated and -untreated patients. Therefore, young women with MOGCT must be reassured of their excellent chances of survival and fertility preservation following conservative surgery and adjuvant platinum-based chemotherapy.

Fertility sparing surgery in malignant ovarian Germ cell tumor (MOGCT): 15 years experiences

“…In previous studies, it was shown that FSS did not affect cancer prognosis in patients with MOGCT [ 30 – 34 ], but the pregnancy rate was not mentioned in most of them [ 29 ]. In this research, menstrual status, number of pregnancies and childbearing situation of the patients are studied.…”

“…Some studies claimed that fertility-sparing surgery was the choice of treatment with ideal survival [ 11 , 17 , 33 , 34 , 36 – 38 ]. This research showed the preserving-fertility treatment may be the best management for young women with MOGCT to preserve fertility.…”

The role of staging surgery in the treatment of apparent early‐stage malignant ovarian germ cell tumours

“…1 These tumours occur mainly in girls and young women, and the cure rate is relatively high as most cases exhibit excellent sensitivity to chemotherapy. Consequently, the extent of surgery is of vital importance to the quality of the patient's life.…”

Non-Epithelial Ovarian Cancers: How Much Do We Really Know?

“…There is concern regarding long-term toxicity of chemotherapy, but Kang et al showed that this regime did not impair ovarian function and fertility [33]. While women stopped menstruating during chemotherapy, over 85% have been shown to regain menstrual function once chemotherapy was completed [35][36][37]. These findings are reassuring that fertility can be preserved in women completing GCT treatment with successful pregnancies shown to match those of the general population [5].…”