Clinical analysis of pregnancy outcome of different fertility-sparing surgery for borderline ovarian tumors

Abstract

Background To retrospectively analyze the different fertility-sparing surgery for patients with borderline ovarian tumors, and study their effects on pregnancy outcome and prognosis, to provide guidance and help clinical workers to choose treatment plans. Methods The clinical data of 325 patients with borderline ovarian tumors who underwent fertility-sparing surgery at Shengjing Hospital of China Medical University from 2015 to 2021 were collected. To understand the pregnancy intention and pregnancy outcome of patients through follow-up. The deadline for follow-up was July 2022. After checking and sorting out the data, SPSS25.0 software was used for statistical analysis. Results Among 325 borderline ovarian tumor patients undergoing fertility-sparing surgery, 118 patients had fertility desire. The postoperative pregnancy rate was 57.63% (68/118), and the natural pregnancy rate was 83.82% (57/68). Univariate analysis showed that the selection of surgical methods and routes and CA125 had significant effects on pregnancy outcomes (P < 0.05). The pregnancy rate after cystectomy was 69.57% (32/46), unilateral salpingo-oophorectomy was 70.83% (17/24), unilateral salpingo-oophorectomy + contralateral oophorectomy/cystectomy was 44.00% (11/25), and stage surgery with fertility preservation was 34.78% (8/23). There was a statistical difference between cystectomy and stage operation with fertility preservation (P < 0.0083). The variables P < 0.10 in univariate analysis were included in the logistic regression analysis. The results showed that the surgical method affected the pregnancy outcome, and the difference was statistically significant (P < 0.05). Conclusion Univariate analysis showed that different surgical methods, surgical approaches, and whether CA125 was positive or not affected the postoperative pregnancy rate of borderline ovarian tumors. Multivariate analysis showed that there was a correlation between the operation mode and the pregnancy outcome after the operation. The pregnancy rate after ovarian cystectomy was better than that of stage operation with fertility preservation. The pregnancy rate after laparoscopy was better than that after laparotomy.