Introduction/Background*The application of fertility sparing surgery (FSS) in patients with clear cell ovarian carcinoma (CCOC) has been extensively criticized, even in patients with stage IA or IC disease, due to the high reported recurrence rates and the resistance to chemotherapy. The objective of the present study was to evaluate the obstetric and fertility outcomes of patients with early stage CCOC following fertility sparing surgery (FSS).

Methodology Three electronic databases were systematically searched for articles published in the field up to December 2020 using the terms “ovarian cancer”, “clear cell”, “fertility sparing”, “conservative treatment”. Studies that reported pregnancy and obstetric outcomes after FSS for the management of early stage CCOC were considered eligible for inclusion.

Result(s)*A total of 5 retrospective studies with 60 patients with CCOC who underwent FSS were included. Mean patients‘ age was 34.8 years. The total clinical pregnancy rate was 32% with a proportion of 24% of live birth rates in 12 of the included patients. The median interval from disease management to pregnancy was 41.5 months. Recurrence rate was 16.6% among the included patients. Survival and recurrence rates were not different in patients who had FSS compared to those who had radical surgery.

Conclusion*Fertility-sparing treatment for stage IA/IC CCOC seems to be an acceptable treatment option for selected women of reproductive age with a strong desire of fertility preservation. Further larger multicenter studies and studies derived from registries are warranted to validate the special aspects of the procedure and to designate the potential candidates who will receive survival and fertility benefit from fertility-sparing surgery.