Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-Gu, Seoul, Republic of Korea.
Curr Opin Obstet Gynecol. 2010 Jun;22(3):227-34. doi: 10.1097/GCO.0b013e3283384928.
Borderline ovarian tumors (BOTs) are a distinct diagnostic category of epithelial ovarian tumors, distinguished from both benign and invasive epithelial ovarian tumors. Because they affect young women of childbearing age, are diagnosed at an early stage, and are associated with excellent prognosis, fertility-sparing options are often used. In this review, we discuss recent findings on the outcomes of fertility-sparing treatments in patients with BOTs.
Reports on the use of fertility-sparing surgery in patients with advanced-stage BOTs and on the application of laparoscopy in fertility-sparing surgery are increasing. As potential alternative, experiences on ovarian tissue cryopreservation have been reported.
Fertility-sparing surgery is the best option to preserve childbearing capacity in young patients with BOTs. Fertility-sparing surgery is well tolerated not only in patients with early-stage BOTs but also in patients with advanced-stage BOTs with noninvasive extraovarian implants, if these implants can be resected completely. After fertility-sparing surgery, pregnancy outcomes are promising and most pregnancies are achieved spontaneously. There are few complications associated with pregnancy, and subsequent pregnancy seems to have little impact on disease course. Fertility drugs are well tolerated in patients with infertility after fertility-sparing surgery for early-stage BOTs, but caution should be exercised when using these drugs after surgery in patients with advanced-stage BOTs. If fertility-sparing surgery is technically not feasible owing to extensive tumor involvement of both ovaries, recent artificial reproductive technologies can be considered, including embryo, oocyte, and ovarian tissue freezing; use of donor oocytes; and surrogacy, but more experience with these options is required.
交界性卵巢肿瘤（BOT）是一种独特的上皮性卵巢肿瘤诊断类别，有别于良性和侵袭性上皮性卵巢肿瘤。由于交界性卵巢肿瘤好发于生育期年轻女性，早期诊断，预后良好，因此通常采用保留生育功能的治疗方法。本文讨论了近期关于交界性卵巢肿瘤患者保留生育功能治疗结局的研究结果。
交界性卵巢肿瘤晚期患者采用保留生育功能手术和腹腔镜在保留生育功能手术中的应用的报道越来越多。此外，也有关于卵巢组织冷冻的经验报道。
对于交界性卵巢肿瘤的年轻患者，保留生育功能手术是保留生育能力的最佳选择。保留生育功能手术不仅在早期交界性卵巢肿瘤患者中耐受良好，而且在具有非侵袭性卵巢外植入物的晚期交界性卵巢肿瘤患者中，如果这些植入物可以完全切除，也可耐受。保留生育功能手术后，妊娠结局是有希望的，大多数妊娠是自发的。与妊娠相关的并发症很少，随后的妊娠似乎对疾病过程影响不大。对于早期交界性卵巢肿瘤保留生育功能手术后不孕的患者，生育药物耐受良好，但在晚期交界性卵巢肿瘤患者手术后使用这些药物时应谨慎。如果由于双侧卵巢广泛受累而在技术上无法进行保留生育功能手术，则可以考虑最近的人工生殖技术，包括胚胎、卵母细胞和卵巢组织冷冻；使用供卵；以及代孕，但需要更多的经验。
