Introduction/Background To present the video of a fertility-sparing surgery in a 34-year old patient with bilateral borderline serous ovarian tumor that consequently permitted successful pregnancy outcome.

Methodology The patient’s medical history and laboratory, imaging and histopathological reports were reviewed in order to comprehensively present the diagnostic approach and course of treatment.

Results A nulliparous 34 year old patient undergoing infertility diagnostic evaluation, is diagnosed with a cystic mass on her right ovary. She is treated with laparoscopic cystectomy, during which biopsies from the healthy ovary are taken, revealing a borderline serous ovarian tumor on the left ovary. After genetic testing shows a PTEN gene mutation, she decides to proceed with ovarian stimulation, oocyte retrieval and embryo cryopreservation. Two months later, new imaging tests are indicative of multiple suspicious cystic masses on both ovaries and potentially metastatic lesions on the right Gerota fascia. The patient, after seeking consultation from the gynecologic oncology team of our ESGO certified Department, undergoes a diagnostic laparoscopy and eventually bilateral salpingo-oophorectomy and surgical staging with peritoneal washing, peritoneal and omental biopsies, finally receiving the diagnosis of borderline serous tumor of the left ovary which has metastasized in the right ovary (IB FIGO stage). After a 6-month follow up period, she proceeded to implant one cryopreserved embryo, which led to a singleton uncomplicated pregnancy and a successful delivery of a healthy neonate via elective cesarean section at gestational age of 38 weeks and 2 days. The patient remains disease-free till today.

Conclusion Fertility preservation is feasible in patients with bilateral borderline ovarian tumors, but the therapeutic management should be individualized for each patient and executed by a multidisciplinary team of specialists, with focus on preserving reproductive ability without compromising oncological safety.

Disclosures Authors declare no conflict of interest.