Objectives Management of early stage ovarian cancer among women of reproductive age remains to be a challenge. This study aimed to determine the survival outcome and predictors of recurrence and survival among these women, with stage IA and IC ovarian cancer after unilateral salpingooophorectomy.

Methodology A 13-year retrospective cohort study was conducted among 34 patients, 40 years and younger, with early stage ovarian cancer who underwent fertility-sparing surgery (FSS) from January 2005 to December 2018. Fertility outcome, recurrence-free survival (RFS) and overall survival (OS) were determined, including prognostic factors for recurrence and survival.

Results Thirty-four of 661 (5.14%) new cases of ovarian cancer underwent FSS, with mean age of 23.71 ± 5.57 years. Successful pregnancy was seen in 9 cases. Recurrence was observed in 14.71% at a median time to recurrence of 31 months (range: 6–39), with three patients dying from the disease after recurrence. Overall RFS in early-stage ovarian cancer was 75% at 37–41 months. A lower probability of RFS was seen among incompletely staged patients, with epithelial type and grade 2 tumors. OS was 80% at 50–52 months after FSS. Complete surgical staging had higher probabilities of OS compared to incompletely staged cases. Epithelial and high grade tumors had lower probabilities of survival and poorer prognosis. Pregnancy has no statistically significant effect on survival and recurrence.

Conclusion Fertility-sparing surgery can be effectively offered to young patients with early stage ovarian cancer. Pregnancy did not adversely affect recurrence and survival of early stage ovarian cancer after unilateral salpingooophorectomy.