In the United States, ovarian cancer (OC) impacts approximately 12% of individuals who are of reproductive age. Several oncologic societies including ASGO, ESGO/ESHRE, and NCCN have released statements advising gynecological oncologists to inform patients of possible infertility and address fertility preservation options prior to initiation of cancer-directed treatment in women of reproductive age. Yet, guidance on how to address infertility and barriers to achieving fertility preservation is lacking. The goal of this review is to define fertility-sparing surgery candidates, provide guidance as to how to optimize fertility by minimizing cancer treatment-related infertility and offering cyropreservation in collaboration with infertility specialists, and discuss possible barriers based on current evidence in young women with spontaneous as well as hereditary ovarian cancer. In addition, we propose an algorithm by which both fertility care and oncologic treatment can be simultaneously expedited. Yet, guidance on how to address infertility and barriers to achieving fertility preservation.
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