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Can Women Conceive after Ovarian Tumors?

Ovarian cancer can really affect the chances of becoming pregnant and giving birth to a healthy child. There are different types of ovarian cancer. One type involves being diagnosed with having borderline ovarian tumors (BOT) in the ovaries. These tumors can adversely affect fertility unless addressed promptly, and there is a study that was recently conducted that shows that there is a possible solution to getting rid of these tumors while keeping fertility intact.

October 28, 2020
Alisha Chunara

Borderline ovarian tumors are defined as unexpected cells found in tissues covering the ovaries that are not considered cancerous, since they don’t grow into the ovary’s stroma and mostly grow slowly and in a more controlled manner than typical cancer cells. These cells can be surgically removed when the tumors are detected at an early stage and the chances of these cells coming back are very small. In addition, these cells very rarely convert into cancerous cells. However, how does one find out that there is a possibility of having borderline ovarian tumors? 

There are some signs that can be observed for borderline ovarian tumors, but they are only apparent when the tumors are in a more advanced stage, or larger, so it is best to have tests and scans such as pelvic examinations or ultrasound scans when there is even a slight suspicion of having borderline ovarian tumors. Some symptoms include:

  • Exhibiting vaginal bleeding that is not related to menstrual bleeding
  • Experiencing pain or a feeling of pressure in the pelvis or abdomen areas
  • Experiencing pain during or after sexual intercourse

There are four stages for borderline ovarian tumors, just like how there are four stages for ovarian cancer: 

  1. Stage 1: The borderline tumors are still within the ovary or ovaries.
  2. Stage 2: The tumors have spread within the pelvic area to places like the fallopian tubes, the womb, the bladder or the rectum.
  3. Stage 3: The tumors have spread outside the pelvic area into the abdominal cavity.
  4. Stage 4: (The advanced stage) The tumors have spread to a different area in the body like the lungs.

Borderline ovarian tumors can only be treated by surgical removal. Even then, they can only be removed with surgery when considering the location of the tumors, if the tumors are spreading, and if there is a desire to bear children some day. If surgery is chosen to remove the borderline tumors, then the there are two broad types of surgery based on where the tumors are: surgery that removes both ovaries, the fallopian tubes, and/or the womb (including the cervix), or surgery that removes the affected ovary and fallopian tube, a procedure similar to that of fertility-sparing surgery.

text reading stages of ovarian cancer and below that are three photos of ovaries that are healthy to late-stage cancer left to right
Basic stages of cancer in the ovaries. Image courtesy of Everyday Health.

Now let's look into the study that may pave the way for an adopted preventative surgery for borderline ovarian tumors.

Analyzing the study

Photo of surgeons in the middle of surgery wearing blue gowns
FSS is not viable for all women, but it is imperative to identify your ovarian tumors at an early stage so that FSS can be an option to remove the tumors and preserve your fertility as well. Image courtesy of Voluson Empowered Women’s Health.

In the study from Karolinska Institutet in Sweden, researchers examined the effects of fertility-sparing surgery (FSS) on fertility in women of a fertile age treated for early-stage borderline ovarian tumors. 

The study focused on analyzing how women in Sweden responded to fertility-sparing surgery in terms of being able to conceive after having the surgery. Generally speaking, the risk of relapsing after fertility-sparing surgery is larger than after radical cancer treatment, in which both ovaries and the uterus are removed. The study consisted of Swedish women between the ages of 18 and 40 who received fertility-sparing surgery for borderline ovarian tumors in the early between the years 2008 and 2015.

Based on the number of women who received the surgery, 23% of the women had successful pregnancies after having the surgery and 9% of the women underwent IVF. In addition, the survival rate for all of the women who were a part of the study was 99%. This means that FSS has a chance of being an adopted operation for those needing treatment for BOTs but wanting to preserve fertility in a safe procedure.

woman in blue dress holding her pregnant stomach
If you beat ovarian cancer, and still retain your fertility, then you’re truly a hero. Image courtesy of Family Fun Canada.

There is no one miracle cure for cancer, at least not yet, but hope should never be diminished, and neither should hope be diminished for solutions for fertility issues.

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