CION Ameerpet
If you are young and have just been told there is a mass on your ovary, the question underneath every other question is usually about children. The honest answer is that for many young women fertility can be protected. What it depends on is the tumour type, the stage, and whether the question is asked before treatment starts rather than after.
For a great many young women, yes. That surprises people, because the ovaries are the organs in question and the assumption is that treatment must take both. Often it does not. Most women searching ovarian cancer fertility are looking for permission to hope, and in a large share of cases the honest clinical answer is that fertility can be protected — provided the question is asked before the first operation rather than after it.
Two facts drive everything else on this page. The first is that ovarian cancer under 40 is usually not the same disease as ovarian cancer at 65. Younger women are far more likely to have a malignant germ cell tumour, a borderline tumour or an early-stage low-grade cancer, and all three are frequently treated by removing one ovary and leaving the uterus and the other ovary alone. The second is that some options expire. Freezing eggs or embryos needs roughly two weeks; once surgery has happened, that window may already have closed.
So this page is about what is possible, what it depends on, and what to ask for. It does not replace the conversation with your own team — it exists to make that conversation better, so fertility is on the table at the first appointment instead of being raised in a corridor afterwards. For the wider picture of the disease, start with the complete ovarian cancer guide or the page on ovarian cancer in young women.
Germ cell, borderline and stage I low-grade tumours — the ones young women most often have — are exactly the ones where fertility-sparing treatment is standard practice, not a favour.
Surgery decides much of your fertility on its own. What is removed cannot be put back, and eggs have to be frozen before treatment, not after it.
Keeping an ovary, freezing eggs, a donor-egg pregnancy in a preserved uterus — these are separate options. Losing one of them does not mean losing all of them.
The single biggest determinant of whether fertility can be preserved is when the conversation happens. ASCO’s fertility preservation guideline is explicit: clinicians caring for patients of reproductive age should discuss the possibility of infertility as early as possible, before treatment starts, and refer anyone who is interested — or even simply uncertain — to a reproductive specialist. Egg and embryo freezing need about two weeks of ovarian stimulation, and once surgery or chemotherapy has begun, several options are no longer available. The conversation is the intervention. Source: Oktay K et al., Fertility Preservation in Patients With Cancer: ASCO Clinical Practice Guideline Update, Journal of Clinical Oncology (2018); NCCN Ovarian Cancer guidelines.
The most useful thing to establish early is which tumour you actually have. It changes the answer more than anything else here. Read this as a map rather than a verdict — stage, ovarian reserve and your own priorities all shape the final plan.
| Tumour type | Who it usually affects | What is usually possible |
|---|---|---|
| Malignant germ cell tumours | Teenagers and women in their twenties and thirties | Fertility-sparing surgery is the standard approach, frequently even when disease has spread, because these tumours respond very well to chemotherapy. Most women menstruate again afterwards. |
| Borderline (low malignant potential) tumours | Often women under 40 | Conservative surgery — removing the cyst or the affected ovary — is usual. Recurrence in the remaining tissue is more likely than after fuller surgery, but survival is not reduced. |
| Sex cord-stromal tumours, including granulosa cell | Any age, including young women | Usually found at stage I. Removing the affected ovary and tube with staging is often enough, and the uterus and other ovary can commonly be kept. |
| Early-stage, low-grade epithelial cancer | Usually over 40, sometimes younger | Fertility-sparing surgery may be considered in carefully selected stage I disease, once full surgical staging has confirmed nothing further is present. |
| High-grade serous epithelial cancer | Most often after 50, but not only | Rarely compatible with keeping the ovaries. The questions shift to whether the uterus can be preserved for a later donor-egg pregnancy, and whether the plan allows time to freeze eggs first. |
| Advanced disease of any type | Any age | A case-by-case conversation between your oncologist and a reproductive-medicine specialist. Not automatically ruled out — weighed against what any delay would cost. |
*Eligibility is settled by surgical staging and pathology, not from a scan alone. Who qualifies, and on what grounds, is set out on who is eligible for fertility-sparing treatment.
There is no single fertility-preservation technique for ovarian cancer. There is a set of them, and which ones apply depends on your tumour, your age and how much time you have. Here is each, plainly.
The most important option, because it costs nothing in time and it shapes everything that follows. The affected ovary and its fallopian tube are removed, along with the surgical staging that confirms disease has not spread; the uterus and the opposite ovary stay. Women who have this can conceive naturally afterwards, and many do.
It is decided by stage and pathology rather than by preference alone, and at CION it is coordinated with specialist gynaecologic-oncology surgeons at partner centres rather than performed in-house. The detail sits on fertility-sparing surgery for ovarian cancer.
Ovarian stimulation, then collection of mature eggs, which are frozen and stored. It suits women without a partner and requires no decision about whose sperm to use. Stimulation takes roughly two weeks, and random-start protocols mean it no longer has to begin at a particular point in your cycle.
The trade-off is time. Two weeks is usually acceptable in borderline and early-stage disease, and often unacceptable in rapidly progressing disease — and that judgement belongs to your oncologist, not to the fertility clinic alone. More on egg and embryo freezing before ovarian cancer treatment.
The same stimulation and collection, with fertilisation before freezing. Embryo survival through freezing and thawing is well established and the results are good. It needs a partner or donor sperm, and a decision — at an extremely difficult moment — about consent and what should happen to stored embryos later.
Both egg and embryo freezing are carried out at a reproductive-medicine unit. CION coordinates the referral and the timing with your cancer plan; the stimulation cycle and the storage sit with the fertility centre and are billed there.
Strips of ovarian cortex are removed and frozen, to be re-implanted after treatment. It is the only technique that needs no stimulation, which makes it valuable when treatment genuinely cannot wait, and in several settings it is now offered as established practice rather than research.
In ovarian cancer specifically it carries a particular concern: tissue taken from an ovary that may harbour disease could reintroduce tumour cells when it is put back. It is therefore used far more cautiously here than in, say, blood cancers, and only after that risk has been discussed openly.
Platinum-based chemotherapy is toxic to the eggs stored in the ovary, and how much damage it does depends heavily on your age and the total dose. A woman in her twenties has far more reserve to lose than a woman in her late thirties, and she is more likely to menstruate again, and sooner.
The regimens used for germ cell tumours are generally less damaging to fertility than long courses given for epithelial disease, and most young women treated for a germ cell tumour do menstruate again and can conceive. Periods returning is reassuring, but it is not the same as a normal ovarian reserve, which is why reserve is worth re-measuring afterwards.
If both ovaries have to be removed but the uterus is preserved, a pregnancy using donor eggs is possible. The uterus does not need ovaries of its own to carry a pregnancy — hormone support does that work. It is a real route to a pregnancy you carry yourself, and it is very often not mentioned early enough.
Where the uterus has also been removed, surrogacy and adoption remain, within the legal framework that applies in India. Naming these is not giving up on the others. It is making sure nobody finds out about the full list two years too late.
If your cancer is linked to a BRCA1 or BRCA2 variant, two further questions arrive at once: whether treatment should change, and whether the variant could pass to a child. Each child of a carrier has a one-in-two chance of inheriting it, whether that child is a son or a daughter.
Pre-implantation genetic testing during IVF can select embryos that do not carry the family variant, and it is available in India. It is a decision with real ethical and emotional weight and it needs proper genetic counselling, not a leaflet. CION provides genetic counselling and BRCA and HRD testing in-house.
None of these is a demand. Each is easy to ask before surgery and impossible to ask after it, and any good team will welcome them rather than bristle at them.
Germ cell, borderline, sex cord-stromal or epithelial — and what grade. This one answer changes what is possible more than anything else.
Ask explicitly whether the uterus and one ovary can be left, and what would have to be found during the operation for that plan to change.
Two weeks is the usual requirement. Ask whether your disease can safely wait that long, and take the answer from your oncologist.
A referral to reproductive medicine before treatment begins is standard guidance, not a special favour. Ask for it at the first appointment.
Ask what is planned, how damaging it is likely to be at your age, and whether ovarian reserve should be measured before it starts.
A fertility-sparing decision should not rest on one clinician. At CION, every case that raises a question goes to multidisciplinary review.
If treatment has already started, none of this is wasted — ovarian reserve can be reassessed afterwards, and pregnancy after ovarian cancer treatment is still possible for many women. Ask the questions late rather than never.
A 45-minute consultation, a clear answer on which tumour type you are actually dealing with, and — where freezing is on the table — a referral made in parallel with surgical planning rather than after it. The options that expire are the ones worth protecting first.
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No referral needed and no cost for the first consultation. Bring the scan, the reports and the question you have not yet said out loud.
The sequence matters as much as the decisions. This is roughly how a case moves when a young woman arrives with a suspicious ovarian mass and wants to keep the option of children.
Forty-five unhurried minutes, in which fertility is raised as a clinical priority rather than an afterthought. Your age, whether you already have children, whether you want them and how soon — these change the plan, so they are asked at the start rather than discovered later.
Pelvic ultrasound, an MRI where the mass is indeterminate, and the right markers for your age: CA-125, plus AFP, beta-hCG, LDH or inhibin B where a germ cell or stromal tumour is a real possibility. Markers in a woman of 26 are read very differently from the same numbers at 60.
Anti-Mullerian hormone and an antral follicle count give a baseline of ovarian reserve before anything is done. Without that baseline, the conversation after treatment has nothing to compare itself against.
Every case that raises a question is discussed by medical oncology, imaging and pathology together, and fertility-sparing eligibility is settled there rather than by one clinician alone. The criteria are set out on who is eligible for fertility-sparing treatment.
Where freezing is on the table, the referral goes out at the same time as surgical planning rather than after it. Two weeks of stimulation only fits into the schedule if the clock starts now. CION coordinates that timing with the fertility unit and with your surgical team.
Staging and fertility-sparing surgery are carried out by specialist gynaecologic-oncology surgeons at partner centres and may be billed there. Chemotherapy, maintenance therapy, genetic counselling, nutrition support and long-term follow-up are delivered in-house at CION, across 35+ centres in Telangana and Andhra Pradesh.
Fertility is the part of an ovarian cancer conversation most likely to be skipped. Not out of indifference — out of time. In a ten-minute consultation the cancer takes all the oxygen, and the question about children gets postponed until after the surgery that has already answered it.
The first consultation at CION is free and runs to about 45 minutes, which is long enough to ask what you actually came to ask. Cases that raise a question go to a tumour board rather than being decided by one doctor, and where a fertility-preservation referral is warranted it is made alongside surgical planning instead of after it.
Be clear about who does what. CION delivers medical oncology in-house: platinum-based chemotherapy and maintenance therapy across 35+ centres, genetic counselling, BRCA and HRD testing, nutrition support and long-term follow-up. Fertility-sparing surgery, staging surgery and any debulking are coordinated with specialist gynaecologic-oncology surgeons at partner centres and may be billed there, and egg or embryo freezing takes place at a reproductive-medicine unit we coordinate with. We would rather say all of that at the beginning than have you find it out in the middle.
Free, and long enough that fertility is discussed before treatment is planned rather than after the decision has already been made for you.
Fertility-sparing eligibility reviewed by medical oncology, imaging and pathology together, not settled by a single clinician in a busy clinic.
Chemotherapy, maintenance therapy, genetic counselling and BRCA and HRD testing delivered by CION across 35+ centres in Telangana and Andhra Pradesh.
Fertility-sparing and staging surgery with partner gynaecologic-oncology centres; egg and embryo freezing with a reproductive-medicine unit, timed around your treatment.
Finishing treatment does not end the fertility conversation. Periods returning is a good sign, but it is not proof of a normal ovarian reserve, and reserve can be measured again a few months later to show where you actually stand. Some women conceive naturally with one ovary. Others need help. A few find the door has closed, and they deserve to be told that clearly rather than left to work it out over years.
On timing, most teams suggest waiting until the period of highest recurrence risk has passed before trying to conceive — often somewhere around two years, though the interval is individual and depends on tumour type and stage. Ask for the number that applies to you rather than the one that applies to everyone. The available evidence has not shown that a later pregnancy makes ovarian cancer more likely to return, and that evidence is strongest for borderline and germ cell tumours. More on pregnancy after ovarian cancer treatment.
You will meet survival statistics while you are reading, so here is the CION figure with the national one beside it: 81.0% of CION ovarian cancer patients are alive at one year, against a national figure of 73.7%. That is one-year survival across an entire treated population — not a cure rate, and not a prediction about you. Your own outlook depends on tumour type, stage and general health, and a young woman with a germ cell tumour sits nowhere near the average that number describes.
A few months after treatment, anti-Mullerian hormone and an antral follicle count show where you are now rather than where you were. It turns guesswork into a plan.
How long to wait before trying to conceive depends on tumour type and stage. A number that applies to you is worth far more than a general rule of thumb.
If both ovaries are removed, menopause arrives at once. Symptoms, bone health and long-term wellbeing are managed actively as part of follow-up at CION.
*One-year survival rates. CION figures reflect CION’s treated patient population; national figures are drawn from published Indian cancer registry data. Survival statistics describe groups, not individuals — discuss your own prognosis with your treating oncologist.
Many women can. It depends chiefly on the tumour type and stage, and on whether the uterus and at least one ovary can be left in place. Young women are far more likely to have germ cell, borderline or early-stage low-grade tumours, and for these, treatment that removes only the affected ovary and tube is frequently appropriate. Women treated that way can conceive naturally afterwards. Where both ovaries must be removed but the uterus is preserved, a donor-egg pregnancy is possible. Where eggs or embryos were frozen before treatment, those remain available. The decisions that matter most are made before the first operation, which is why the question should be raised at the very first appointment.
It means removing the affected ovary and its fallopian tube, with full surgical staging, while leaving the uterus and the opposite ovary in place. It is the standard approach for most malignant germ cell tumours, even when disease has spread, because they respond so well to chemotherapy. It is usual for borderline tumours and often appropriate for stage I sex cord-stromal tumours. In epithelial ovarian cancer it is considered only in carefully selected early-stage, low-grade disease. Eligibility is confirmed by staging and pathology rather than by a scan, so the final answer sometimes comes during or after the operation. At CION this surgery is coordinated with specialist gynaecologic-oncology surgeons at partner centres and may be billed there.
It is worth asking about in every case, because the answer depends on time rather than on willingness. Ovarian stimulation and egg collection take roughly two weeks, and random-start protocols mean the cycle no longer has to begin at a set point in your menstrual cycle. In borderline disease and many early-stage cancers, a two-week delay is usually acceptable. In rapidly progressing disease it may not be, and that judgement belongs to your treating oncologist rather than to the fertility unit. If a partner or donor sperm is available, embryos can be frozen instead, which has a longer track record. Both are carried out at a reproductive-medicine unit, with the timing coordinated around your cancer plan.
Not always, and the risk varies a great deal. Platinum-based chemotherapy damages the eggs held in the ovary, and how much depends most on your age and the total dose given. Women in their twenties start with far more ovarian reserve than women in their late thirties, so they are more likely to menstruate again and to do so sooner. The regimens used for germ cell tumours are generally less damaging than long courses for epithelial disease, and most young women treated for a germ cell tumour do have periods again and can conceive. Periods returning is encouraging, but it is not the same as a normal reserve, so it is worth re-measuring anti-Mullerian hormone and follicle count a few months after treatment ends.
Yes, and this is one of the more reassuring facts in the whole subject. A single healthy ovary ovulates in most cycles rather than in alternate ones, and pregnancy rates after removal of one ovary are close to those of women with both, particularly in younger women. What changes is the margin: there is less reserve in the bank, so the number of years available to conceive may be shorter. That is worth knowing rather than fearing. If you are planning to wait several years before trying, it is a reason to discuss ovarian reserve testing, and possibly egg freezing after treatment, rather than a reason to rush a decision you are not ready to make.
There is no single number that fits everyone. Most teams suggest waiting until the period of highest recurrence risk has passed, which is often somewhere around two years, but the right interval depends on tumour type, stage and how treatment went. Borderline and germ cell tumours are frequently treated differently from epithelial cancer in this respect. Ask your own oncologist for the interval that applies to your case, and ask again if the first answer sounds generic. Available evidence has not shown that a later pregnancy makes ovarian cancer more likely to return, and that evidence is strongest in borderline and germ cell disease. Follow-up continues in the usual way during and after a pregnancy.
Each child of a BRCA1 or BRCA2 carrier has a one-in-two chance of inheriting the variant, and that is true for sons as well as daughters. Pre-implantation genetic testing during IVF can identify embryos that do not carry the family variant, and it is available in India. It is a demanding route, both practically and emotionally, and it needs proper genetic counselling rather than a quick conversation. There is also the separate question of timing: BRCA carriers are usually advised to consider risk-reducing surgery once childbearing is complete, so family planning and that decision are best discussed together. CION provides genetic counselling and BRCA and HRD testing in-house.
The first consultation is free and runs to about 45 minutes. CION delivers medical oncology for ovarian cancer in-house, which covers chemotherapy and maintenance treatment across more than 35 centres in Telangana and Andhra Pradesh, along with genetic counselling and BRCA and HRD testing where family history or the diagnosis warrants it, nutrition support and long-term follow-up. Fertility-sparing surgery, staging surgery and debulking are coordinated with specialist gynaecologic-oncology surgeons at partner centres and may be billed there, and egg or embryo freezing takes place at a reproductive-medicine unit we coordinate with. We say that upfront rather than leaving it to be discovered later. Every case that raises a question is reviewed at a tumour board.