Introduction/Background To evaluate pregnancy outcomes in patients diagnosed with stage I ovarian dysgerminoma who underwent a fertility-sparing surgery in a tertiary-care center in Monza, Italy. Methodology We performed a retrospective, observational study of women with a histologically confirmed diagnosis of ovarian dysgerminoma referred to our Institution from 1980 to 2020. We collected patients' characteristics, surgical procedures and postoperative management. Descriptive statistics were

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... rformed for baseline characteristics, while Fisher's exact test was used to investigate the association between type of surgery (ovarian cyst removal [CR] versus unilateral salpingo-oophorectomy [USO]), oncologic management (adjuvant chemotherapy [AC] versus follow-up [FU]) and pregnancy outcome. P<0.05 was considered significant. Results Of 131 patients diagnosed with ovarian dysgerminoma, 49 were diagnosed withearly-stage disease, treated with fertility-sparing surgery and received follow-up at our Institution. During follow-up 18 patients never planned a pregnancy or had already completed childbearing while 31 patients tried to conceive, with a live birth rate of 96.7%. No differences in delivery rate were found either between patients managed with CR only (3/31) and with USO (28/ 31), or between patients who received AC after surgery (12/ 31) and those who received follow-up only (19/31). Six patients reached physiologic menopause: mean age at menopause was 51.7 years. Conclusion Fertility-sparing surgical treatment is safe and feasible for patients with early-stage ovarian dysgerminoma. In our population, live birth rate was not affected by the type of surgery or postoperative oncologic management; the effect of fertility-sparing surgery for early-stage ovarian dysgerminoma on age at menopause should be further investigated.