Micrognathia is a congenital facial abnormality characterised by a small mandible and a receding chin. Antenatal diagnosis is based on subjective assessment, although objective measurements have been proposed including inferior facial angle and frontal nasomental angle. 1 With a 1 in 1500 birth prevalence, it is a rare congenital defect, with a mortality rate of up to 80% due to its frequent association with other chromosomal abnormalities, particularly trisomy 18, and other genetic syndromes. [2][3][4][5] Isolated micrognathia carries a better prognosis than when associated with other congenital anomalies. However, these associated anomalies, such as cleft palate, may be difficult to identify antenatally, justifying guarded antenatal counselling. 6 Despite advances in

Fertility Sparing Surgery (FSS) appears to be a safe means of treating early-stage ovarian cancer based on relatively limited evidence. However, there is currently insufficient evidence to aid women in counselling about their potential fertility outcomes. The aim of this study was to assess the reproductive outcomes and prognosis of women who have undergone FSS for ovarian malignancy. Between 1 June 2008 and 1 June 2018, a retrospective review of a clinical database was conducted to identify all consecutive patients who underwent FSS in a central London gynaecological oncology centre. All patients with a histological diagnosis of ovarian malignancy (excluding borderline ovarian tumours) were eligible. All identified patients were then prospectively called into a follow up and asked to complete a questionnaire about their fertility outcomes. A total of 47 women underwent FSS; 36 were included in this study. The mean age was 30.3 years (95% Confidence Interval [CI]: 27.6 to 33.0 years). During the study period, 17/36 (47.2%) of the women had attempted to conceive following surgery, with a successful live birth rate of 52.9% (9/17). The mean time of recurrence was 125.3 months (95% CI: 106.5–144.1 months). The mean time to death was 139.5 months (95% CI: 124.3–154.8). The cancer grade, tumour stage and use of Assisted Reproductive Technology (ART) were the main factors significantly associated with the risk of recurrence and death. In conclusion, this study suggests that a large proportion of women will not attempt to conceive following FSS. For those who do attempt to conceive, the likelihood of achieving a live birth is high. However, careful counselling about the higher risk of recurrence and worse survival for women with high grade cancer, disease Stage > IA and potentially those who undergo ART is essential before contemplating FFS.

This article includes Author Insights, a video abstract available at: https://vimeo.com/733549553.