Fertility Sparing Surgery Upon Reproductive and Oncologic results in Ovarian Cancer patients Stage I (FIGO): A Systematic Review

Purpose This systematic review evaluates the oncologic and reproductive outcomes of fertility-sparing surgery (FSS) in women diagnosed with stage I ovarian cancer, as classified by the International Federation of Gynecology and Obstetrics (FIGO). The goal is to assess the safety and effectiveness of FSS in preserving fertility without compromising survival outcomes. Methods A systematic search was conducted in MEDLINE (PubMed), SCOPUS, and Google Scholar for studies published in English from 2014 onward. Studies involving women under 50 with stage I ovarian cancer who opted for FSS were included. Data extraction focused on oncologic outcomes (recurrence and survival rates) and reproductive outcomes (pregnancy and live birth rates). Study selection followed PRISMA guidelines. Results Seventeen studies comprising 1030 patients met the inclusion criteria. Pregnancy success rates ranged from 25–91.3%, with live birth rates exceeding 80% in most studies. Spontaneous conception was predominant, though 3.7–28% of patients required assisted reproductive technologies (ART). Despite 58% of patients expressing a desire for future pregnancy, only 13% actively attempted conception. Recurrence rates varied from 3–33.3%, with most studies reporting between 8% and 15%. Overall survival ranged from 88–100%, and disease-free survival remained above 90%. The highest recurrence was observed in mucinous ovarian carcinoma and FIGO Stage IC2/IC3 subtypes. Conclusion FSS in stage I ovarian cancer is a viable alternative to radical surgery in carefully selected patients, with favorable oncologic and reproductive outcomes. However, recurrence risks and fertility challenges highlight the need for multidisciplinary counseling, long-term surveillance, and further research to refine selection criteria and optimize fertility preservation techniques.