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Women with Certain Type of Ovarian Cancer May Preserve Fertility

For many women, undergoing treatment for ovarian cancer means losing the ability to experience childbirth later in life. However, a recent study finds that women diagnosed with a certain type of ovarian cancer called germ cell tumors may be able to preserve their fertility while receiving sufficient treatment. Treatment for this type of cancer typically involves surgery, followed by chemotherapy. In the study, many women who had only one ovary removed were able to successful have children after treatment.

Ovarian cancer is the sixth most common cancer among women and the fifth leading cause of cancer deaths in women. There are several different types of ovarian cancer. The most common form, epithelial carcinoma, develops on the surface of the ovary (the epithelium). A second type of ovarian cancer, a germ cell tumor, is less common than epithelial carcinoma and occurs when cancer develops in the egg-producing cells of the ovaries. A third type of ovarian cancer, a stromal tumor, is rare; it occurs when cancer develops in the supporting tissue of the ovary.

To study whether women diagnosed with cancerous germ cell tumors were able to have children after treatment, Dr. Peter Schwartz and his team at Yale University School of Medicine studied 86 women who had been treated for germ cell tumors between 1975 and 1995. Sixty-four of the 86 women had had only one ovary removed during treatment.

The researchers obtained information about the women’s fertility via telephone and mail. They learned that 38 of the women had attempted to become pregnant after their ovarian cancer treatment, and 29 of those women successfully gave birth. Among 16 women for whom information about their children was available to researchers, none reported any birth defects.

According to Dr. Schwartz and his colleagues, women who are diagnosed with germ cell tumors should be aware that there are high chances that fertility can be preserved after conservative surgery to one ovary or combined treatment with chemotherapy. Furthermore, women with a history of germ cell tumors are not at high risk of having children with developmental abnormalities or other birth defects.

In fact, in the study, four women had undergone treatment for ovarian germ cell tumors prior to the onset of menstruation. These women each experienced normal menstrual periods after treatment, and one woman who attempted to have a child was successful.

The key to preserving fertility with germ cell tumors is early detection. Indeed, ovarian cancer is highly treatable when detected in early stages. However, many cases of ovarian cancer are not diagnosed until advanced stages. This is because the symptoms of ovarian cancer can be very subtle ("silent") or unnoticeable until the disease has progressed significantly. Symptoms of ovarian cancer include pelvic/abdominal pain, gastrointestinal problems, frequent urination, changes in bowel habits, weight gain or loss, pain during sexual intercourse, fatigue, leg pain, or unusual vaginal bleeding. If any of these symptoms persist, women should inform their physicians and undergo clinical examination.

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