The goal of the treatment of children and adolescents with germ cell ovarian tumors is to save both life and its quality. One of the quality of life issue in pediatric patients is fertility preservation. The removal of the ovary on the affected side allows saving the ovary on the opposite side. The single ovary is able to save further full development of female secondary sexual characteristics and will play important role as psychological value. In addition, the reproductive function will be stored. Chemotherapy may badly impact the function of a single ovary. To find out in advance how chemotherapy will affect ovarian function is impossible, so it is necessary for patients with Stage I ovarian germ cell tumors to decide the possibility of dismissing chemotherapy from the treatment. Under certain conditions unilateral salpingo-oophorectomy may be sufficient for stage I disease. Risk factors which should be considered when refusing chemotherapy are discussed.

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