Does controlled ovarian hyperstimulation in women with a history of borderline tumor influence recurrence rate?

Arch Gynecol Obstet. 2024 Apr;309(4):1515-1523. doi: 10.1007/s00404-023-07103-8. Epub 2023 Sep 26.

Abstract

Purpose: To determine the recurrence rate in the women with controlled ovarian hyperstimulation after a history of borderline ovarian tumors (BOT).

Methods: This was a retrospective analysis of 275 patients with BOT undergoing surgery for fertility preservation in our hospital between 2001 and 2017. Cases were divided into an assisted reproductive technology (ART) treatment group (n = 15) and a non-ART treatment group (n = 260). We compared the recurrence rate, survival rate and pregnancy outcomes between these two groups.

Results: The ART group had a higher recurrence rate (33.33% vs. 10.80%, P = 0.023). Survival analysis indicated that the recurrence time in patients undergoing ART was significantly shorter (P = 0.026). A low pregnancy rate before diagnosis, and high intraoperative blood loss, were associated with postoperative ART treatment (P < 0.05). Multivariate analysis showed that ART treatment and bilateral lesions both significantly increased the risk of recurrence (P < 0.05). The pathological type of recurrent tumors was often the same as the initial tumor.

Conclusion: The postoperative use of ART in patients with BOT significantly increased the recurrence rate, but does not significantly affect the overall survival rate of patients. Therefore, ART in such patients should be individualized, and close follow-up is necessary after ART.

Keywords: Assisted reproductive technology; Borderline ovarian tumors; Fertility preservation; Overall survival; Recurrence rate.

MeSH terms

  • Female
  • Fertility Preservation*
  • Humans
  • Neoplasm Recurrence, Local / pathology
  • Ovarian Neoplasms* / pathology
  • Ovarian Neoplasms* / surgery
  • Precancerous Conditions*
  • Pregnancy
  • Pregnancy Outcome
  • Reproductive Techniques, Assisted
  • Retrospective Studies