When is Fertility Preserving Surgery Possible?
Fertility preservation is NOT for all patients — it is offered only in carefully selected cases where it is oncologically safe.
What is Fertility Preserving Surgery?
Fertility preserving surgery is an approach where cancer treatment is done safely while preserving the uterus and/or reproductive potential, so that a woman can have a future pregnancy.
In simple terms:
- Treat the disease without taking away the chance of motherhood
Who performs fertility-preserving ovarian cancer surgery in Ahmedabad?
Dr Swati Shah, MS, DNB (Robotic UroGynec Oncosurgeon), performs fertility-preserving ovarian tumour and ovarian cancer surgery at Apollo Hospital, Bhat, Gandhinagar, and consults at Gota, Ahmedabad.
What is fertility-preserving ovarian surgery?
It is cancer surgery that removes the affected ovary or tumour while keeping the uterus and the healthy ovary, so a future pregnancy remains possible.
Who is suitable for fertility-preserving ovarian surgery?
Young women with an early-stage tumour confined to one ovary, a favourable tumour type on frozen section, and no disease elsewhere in the abdomen.
Does preserving fertility make ovarian cancer treatment less safe?
Not in correctly selected early-stage disease. Staging is still completed in full, and the plan changes to standard surgery if frozen section or staging shows wider disease.
Can a woman conceive after fertility-preserving ovarian surgery?
Yes. One healthy ovary and an intact uterus are usually enough to conceive, naturally or with assisted reproduction after treatment is complete.
When must both ovaries be removed?
When both ovaries carry tumour, when the stage is advanced, or when the tumour type carries a high risk of relapse. Egg or embryo freezing is discussed before surgery in that case.
Treatment is not decided only before surgery How Treatment is Planned
Final decisions are made during surgery using:
- Resection without rupture
- Frozen section (LIVE biopsy)
This allows:
Right surgery to be performed in a single operation
Why Biopsy Should Be Avoided Before Surgery
In most ovarian masses, preoperative biopsy is NOT recommended
1. Risk of Tumour Rupture
- Needle biopsy can puncture the cyst/tumour
- Leads to spillage → cancer spread
2. Does Not Change Treatment Plan
- If biopsy shows cancer → surgery is still required
- If biopsy shows no cancer → not reliable (only small sample taken)
3. False Reassurance Risk
- A negative biopsy does NOT rule out cancer
Indications for Fertility Preserving Surgery
Fertility preservation is offered only in carefully selected patients where it is considered oncologically safe.
1
Early Stage Ovarian Cancer
- Disease limited to ovary/ovaries
- No spread on imaging or surgery
- Stage IA → uterus + one ovary preserved
- Stage IB → uterus preserved for IVF possibility
Not recommended in Stage IC due to higher recurrence risk
2
Borderline Ovarian Tumours
Low malignant potential
Excellent outcomes with fertility preservation
One of the most common indications for fertility-sparing surgery
3
Germ Cell Tumours
Common in young patients
Highly chemosensitive with excellent survival
Fertility preservation is standard of care in most cases
4
Selected Low-Grade Tumours
Early-stage, low-grade epithelial cancers
Requires strict selection and detailed counselling before surgery
Safety First
When Fertility Preservation is NOT Safe
Fertility preservation is avoided whenever cancer control and long-term survival may be compromised.
Not considered safe in:
- Advanced ovarian cancer (Stage II–IV)
- High-grade aggressive tumours
- Extensive disease inside abdomen
What is Preserved?
Fertility-preserving surgery aims to safely maintain future reproductive potential whenever oncologically appropriate.
Uterus Preserved
One Ovary Preserved (if uninvolved)
Stage IB → uterus preserved even if ovaries removed
Affected ovary/tumour is removed carefully without rupture to maintain oncological safety.
Role of Frozen Section (LIVE Decision Making)
During Surgery
Frozen section (LIVE biopsy) helps:
• Confirm tumour type
• Decide whether fertility can be preserved
Ensures:
Right decision during the same surgery
Surgical Approach
Open / Laparoscopic / Robotic
Depends on:
Tumour size
Risk of rupture
Suspicion of cancer
Priority:
Complete tumour removal without spillage
Cancer Staging is Still Done
Proper Cancer Staging
Even in fertility preserving surgery, proper cancer staging is mandatory.
This includes:
- Omentectomy
- Lymph node assessment/dissection
- Peritoneal evaluation
Oncologic Principles
Same oncologic principles as standard cancer surgery are followed
- Does not affect fertility if done meticulously
Importance of Proper Case Selection
Fertility preservation is a balanced and expert decision:
Preserve fertility
Without compromising cancer outcome
Requires:
Imaging
Tumour markers
Intraoperative judgement
Experienced gynecologic oncologist
Chances of Pregnancy After Surgery
- Many patients conceive naturally if one ovary is preserved
-
In Stage IB:
Pregnancy possible via IVF (donor egg) - Uterus preservation allows future pregnancy options
Risks & Follow-Up
- Small risk of recurrence
- Requires regular follow-up and monitoring
- Careful long-term surveillance is essential
Why Choose a Specialized Centre?
- Expertise of a gynecologic oncologist
- Frozen section availability
- Accurate staging and judgement
- Preserve fertility without compromising cure
Lets be Informed
Google Reviews
Read real stories from patients across India who trusted our specialized surgical protocols for their recovery.
- Knowledge Shorts
Watch our expert-curated shorts for quick, clear answers on diagnosis, treatment & more.
- Video testimonials
Video testimonials feature satisfied patients and clients sharing authentic stories to build trust and credibility.
This video features a heartfelt testimonial from the family of an ovarian cancer survivor, detailing her successful treatment for a borderline ovarian tumor. Hailing from Kutch, Gujarat, the patient’s journey began when a lump was discovered in her ovary. Seeking specialized care, her family was referred to Dr. Swati Shah, a Uro and Gynecological Oncologist at HCG Hospital. The patient underwent a surgical procedure to treat the tumor. In the video, her son explains that she stayed in the hospital for about 10 to 11 days for her surgery and initial recovery.
Diagnosed with the condition, she traveled from Rajkot to receive specialized care from Dr. Swati Shah, a Robotic Uro-Gynec Onco Surgeon in Ahmedabad. The patient underwent a radical ovarian surgery. In the video, her family member speaks highly of the treatment they received, expressing their satisfaction with both the surgery and the level of care provided. He mentions that the operation was successful and that Dr. Swati Shah’s expertise was commendable. The family also praises the entire medical staff for their exceptional support and cooperation throughout the treatment process.
- Case Summaries
Case summaries provide concise overviews of patient diagnoses, advanced treatments, and successful clinical recovery outcomes.
Exploratory Laparotomy And Complex Excision For A Suspicious Right Adnexal Mass
- The Challenge
- Managing A Suspicious Pelvic Mass
A 49-year-old female presented with severe lower abdominal pain persisting for fifteen days, alongside an alarming heterogenous solid-cystic right pelvic mass. Imaging strongly suggested a neoplastic etiology with pelvic lymphadenopathy, necessitating highly urgent surgical intervention to rule out an aggressive ovarian malignancy.
The Solution
⦿ Comprehensive Exploratory Laparotomy
Dr. Swati Shah performed an exploratory laparotomy, right adnexal mass excision, left oophorectomy, appendicectomy, bilateral pelvic lymph node dissection, and omental biopsy. The team navigated complex adhesions, carefully separating the appendix from the tumor. This exceptional surgical precision ensured complete tissue removal and maximized patient safety.
» Surgical Highlights & Precision
• Procedure: An exploratory laparotomy with adnexal excision and appendicectomy was meticulously executed.
• Pelvic Lymph Nodes: Bilateral pelvic lymph node dissection yielded seventeen nodes for comprehensive pathological evaluation.
• Blood Loss: Superior hemostatic control resulted in an exceptionally minimal estimated blood loss of 100 ml.
• Complete Clearance: All suspicious masses and adherent structures were successfully excised without compromising surrounding tissues.
» The Outcome
⦿ Uneventful Recovery And Favorable Pathology
The patient experienced an entirely uneventful postoperative recovery and was discharged with stable hemodynamics. Final histopathology remarkably revealed xanthomatous salpingooophoritis and acute appendicitis, confirming absolutely no malignancy was present. The patient successfully regained ambulatory function and safely transitioned to a comfortable recovery at home.
» Dr. Swati Shah’s Insight
Navigating a highly suspicious pelvic mass with severe adhesions requires absolute surgical precision. By comprehensively excising the involved tissues, we achieved a definitive benign diagnosis, securing the patient's excellent long-term health.
Advanced Surgical Management of Metastatic Ovarian Carcinoma Secondary to Breast Cancer
- The Challenge
- Complex Metastatic Presentation
A 45-year-old female presented with bilateral adnexal masses, signaling a metastatic spread from a previously treated left breast carcinoma. The case was particularly complex due to the patient’s extensive history of prior chemotherapy, mastectomy, and the aggressive, recurrent nature of the metastatic disease requiring urgent intervention.
The Solution
⦿ Comprehensive Exploratory Laparotomy and Multimodal Cytoreduction
Dr. Swati Shah performed a meticulous diagnostic laparoscopy followed by a formal exploratory laparotomy, total abdominal hysterectomy, and bilateral salpingo-oophorectomy. Precision in surgical technique was paramount to safely resect the adnexal masses while performing an infracolic omentectomy, ensuring the complete removal of all visible metastatic deposits within the abdominal cavity.
» Surgical Highlights & Precision
• Procedure: A comprehensive cytoreductive surgery involving diagnostic laparoscopy, laparotomy, hysterectomy, and infracolic omentectomy was successfully performed.
• Anatomical Complexity: The surgical team navigated challenging bilateral adnexal masses to ensure complete tumor excision from the ovaries.
• Safety & Hemostasis: Exceptional surgical precision was maintained throughout the procedure, resulting in minimal blood loss of 100 ml.
• Cancer Clearance: The procedure achieved a successful oncological outcome with final pathology confirming the removal of all involved tissues.
» The Outcome
⦿ Stable Recovery and Pathological Success
Postoperatively, the patient remained hemodynamically stable and was mobilized shortly after the intervention. Pathological evaluation confirmed the successful resection of metastatic carcinoma with clear margins, while the uterus and parametria remained uninvolved. The patient experienced an uneventful recovery and was discharged in stable condition to continue her ongoing oncological management.
» Dr. Swati Shah’s Insight
In cases of metastatic breast cancer involving the ovaries, a meticulous surgical approach is vital to managing the disease burden effectively. By utilizing a comprehensive cytoreductive strategy, we can achieve optimal outcomes and provide our patients with the best chance for long-term survival.
Before Surgery Consultation
Consult Before Surgery
Young and diagnosed with ovarian cyst/tumour
Planning future pregnancy
Discuss fertility options before surgery, as decisions are made during the first operation
Frequently Asked Questions
Yes, in selected early-stage cases with fertility preservation.
Yes. One healthy ovary is usually sufficient.
Pregnancy is still possible using IVF with donor egg, if uterus is preserved.
Only in carefully selected patients under expert care.
Not always. Many patients conceive naturally.
Look for a gynaecologic oncologist who does staging and fertility-sparing surgery routinely and works with an on-table frozen-section service. Dr Swati Shah, MS, DNB (Robotic UroGynec Oncosurgeon), performs these operations at Apollo Hospital, Bhat, Gandhinagar.
Fertility-preserving ovarian cancer surgery in Gujarat is performed at Apollo Hospital, Bhat, Gandhinagar, where Dr Swati Shah, MS, DNB (Robotic UroGynec Oncosurgeon), operates. Consultations are at Gota, Ahmedabad.
Yes, and it is worth asking for one before surgery rather than after. Bring the pelvic ultrasound or MRI, the CT abdomen, CA-125 and any biopsy report so the fertility-sparing option can be assessed properly.
It is discussed when both ovaries are likely to be removed or when chemotherapy is expected. The decision depends on how urgent surgery is, since stimulation takes about two weeks.
Usually after treatment is complete and the first surveillance scans are clear. The exact interval depends on the tumour type and whether chemotherapy was needed, and is set case by case.
Dr Swati Shah, MS, DNB (Robotic UroGynec Oncosurgeon), અમદાવાદમાં ફર્ટિલિટી પ્રિઝર્વિંગ ઓવેરિયન સર્જરી કરે છે. ઓપરેશન Apollo Hospital, Bhat, Gandhinagar ખાતે થાય છે અને કન્સલ્ટેશન Gota, Ahmedabad માં.
