Introduction The gynaecological oncofertility service was set up with the aim to provide holistic counselling to young women with gynaecological cancers, to optimize their fertility potential in survivorship. We report our experience in fertility sparing management in ovarian tumours.

Methods Over a period of 30 months, 69 young women with suspicious ovarian masses were reviewed at the oncofertility clinic. Patients were jointly counselled by gynaecological oncologists and fertility specialists, elaborating fertility-sparing staging surgery (FSS) and fertility preservation (FP) options. FP was offered prior to completion surgery or adjuvant chemotherapy, and when the ovarian reserve was deemed diminished and at risk. Dedicated counselling and psychosocial support was provided by a specialty nurse.

Results The median age was 28 years. 88.4% of patients were nulliparous. Of 64 patients who underwent surgery, there were 23 borderline, 32 malignant, 1 Krukenberg and 9 benign ovarian tumours. FSS was performed in 90.6% of ovarian cancer (OC) cases. Among patients with borderline ovarian tumours (BOT), ovarian cystectomies and unilateral salpingoophorectomies were performed in 77.3% and 22.7% of cases respectively. The median stage was IC1 for OC and IB for BOT. 50% of patients had adjuvant chemotherapy. There were 6 suspected recurrences, 5 of whom underwent surgery with benign histology. Twenty-two patients were offered FP and 4 patients underwent oocyte or embryo cryopreservation. There were 4 spontaneous pregnancies with 2 livebirths, and 3 patients currently undergoing assisted reproductive therapy.

Conclusion/Implications Through multidisciplinary oncofertility care, young females with ovarian tumours can achieve favourable oncologic and reproductive outcomes with FSS and early FP counselling.