Fertility preservation strategy in advanced ovarian cancer: A case report


  • Derya Ozdemir Tas Ankara Bilkent City Hospital
  • Yasemin Yuksel Ankara Bilkent City Hospital
  • Zehra Kurdoglu Ankara Bilkent City Hospital




Immature teratoma, fertility preservation, pregnancy, live birth


Ovarian germ cell tumors arise from the primary germ cells located within the ovary. These tumors may manifest as either non-malignant, exemplified by mature teratomas, or malignant, dysgerminomas, yolk sac tumors, and mixed germ cell neoplasms. In this case presentation, we describe a patient who, at the age of 24, underwent a fertility-preserving approach (egg and embryo freezing) due to the suspicion of malignancy in the remaining ovary during routine check-ups, while in remission from an immature teratoma (grade 2). The patient received in vitro fertilization treatment, and a random-start ovarian stimulation protocol was applied with GnRH antagonist and aromatase inhibitor. Subsequently, egg retrieval and embryo freezing procedures were performed. After the removal of the suspected cyst and left salpingectomy operation six months later, the patient underwent a frozen embryo transfer. Pregnancy and live birth occurred for a woman who had been in ovarian cancer remission for ten years. This case report demonstrates that patients with malignant ovarian germ cell tumors can become pregnant and give birth if they wish.


Shaaban AM, Rezvani M, Elsayes KM, Baskin H Jr, Mourad A, Foster BR, et al. Ovarian malignant germ cell tumors: cellular classification and clinical and imaging features. Radiographics. 2014;34(3):777-801.

Sagae S, Kudo R. Surgery for germ cell tumors. Semin Surg Oncol. 2000;19(1):76-81.

Norris HJ, Zirkin HJ, Benson WL. Immature (malignant) teratoma of the ovary: a clinical and pathologic study of 58 cases. Cancer. 1976;37(5):2359-2372.

Euscher ED. Germ Cell tumors of the female genital tract. Surg Pathol Clin. 2019;12(2):621-649.

Wang D, Zhu S, Jia C, Cao D, Wu M, Shen K, et al. Role of staging surgery and adjuvant chemotherapy in adult patients with apparent stage I pure immature ovarian teratoma after fertility-sparing surgery. Int J Gynecol Cancer. 2020;30(5):664-669.

The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum Reprod. 2011;26(6):1270-1283.

Ayensu-Coker L, Essig E, Breech LL, Lindheim S. Ethical quandaries in gamete-embryo cryopreservation related to oncofertility. J Law Med Ethics. 2013;41(3):711-719.

Nasioudis D, Frey MK, Chapman-Davis E, Caputo TA, Holcomb K. Fertility-preserving surgery for advanced stage ovarian germ cell tumors. Gynecol Oncol. 2017;147(3):493-496.

Jorge S, Jones NL, Chen L, Hou JY, Tergas AI, Burke WM, et al. Characteristics, treatment and outcomes of women with immature ovarian teratoma, 1998-2012. Gynecol Oncol. 2016;142(2):261-266.

Kim SS. Ovarian stimulation for fertility preservation in women diagnosed with cancer. Fertil Steril. 2018;110(7):1269-1270.

Hussein RS, Khan Z, Zhao Y. Fertility preservation in women: Indications and options for therapy. Mayo Clin Proc. 2020;95(4):770-783.

Danis RB, Pereira N, Elias RT. Random start ovarian stimulation for oocyte or embryo cryopreservation in women desiring fertility preservation prior to gonadotoxic cancer therapy. Curr Pharm Biotechnol. 2017;18(8):609-613.

Benard J, Benoit A, Sonigo C, Grynberg M. Fertility preservation in women. In: Huhtaniemi I, Martini L, editors. Encyclopedia of Endocrine Diseases (Second Edition). Oxford: Academic Press; 2019:603-614.

Burns KC, Hoefgen H, Strine A, Dasgupta R. Fertility preservation options in pediatric and adolescent patients with cancer. Cancer. 2018;124(9):1867-1876.

Iavazzo C, Vorgias G, Iavazzo PE, Gkegkes ID. Fertility sparing approach as the standard of care in young patients with immature teratomas. J Turk Ger Gynecol Assoc. 2017;18(1):43-47.

Alwazzan AB, Popowich S, Dean E, Robinson C, Lotocki R, Altman AD. Pure ımmature teratoma of the ovary in adults: thirty-year experience of a single tertiary care center. Int J Gynecol Cancer. 2015;25(9):1616-1622.




How to Cite

Ozdemir Tas, D., Yuksel, Y., & Kurdoglu, Z. (2024). Fertility preservation strategy in advanced ovarian cancer: A case report. Journal of Social and Analytical Health, 4(1), 24–27. https://doi.org/10.5281/zenodo.10976087