随着全球卵巢肿瘤患者呈逐年年轻化发病趋势，保留生育功能手术(FSS)作为一种兼顾肿瘤控制与生育保留的治疗策略，近年受到本领域广泛关注。卵巢肿瘤包括交界性卵巢肿瘤(BOT)、早期上皮卵巢癌(EOC)和非上皮性卵巢癌(NEOC)。对于BOT育龄患者，单侧附件切除术或囊肿剥除术，均可为其保持良好生育功能预后，而且与根治性手术比较，不显著影响肿瘤复发率。早期EOC患者，尤其是国际妇产科联盟(FIGO)临床分期为Ⅰ期、分化程度较好的EOC，针对育龄患者采取FSS治疗措施，在总体生存(OS)率上表现良好，但是针对EOC某些亚型，如高级别子宫内膜样卵巢癌，存在患者预后较差可能。对于符合FSS适应证的NEOC中的生殖细胞肿瘤和性索间质肿瘤育龄患者采取FSS治疗措施，与未采取FSS治疗措施的符合FSS适应证患者比较，则展示较好生存结局和妊娠结局。辅助生殖技术(ART)为卵巢肿瘤患者生育力保存提供了有效方法，冷冻卵子、胚胎及卵巢组织为患者提供了生育选择。在严格筛选卵巢肿瘤FSS适应证患者后，对其采取FSS治疗是一种可行、安全，并且有效的治疗方案。目前针对BOT和恶性卵巢肿瘤育龄患者开展FSS尚面临诸多挑战，如适应证界定、手术方式决策、长期预后评估及个体化治疗策略建立与ART的联合应用等。笔者拟就临床针对卵巢肿瘤，包括BOT、早期EOC和NEOC育龄患者进行FSS，以及评估不同类型卵巢肿瘤育龄患者的FSS安全性和生育结局的最新研究现状进行阐述，旨在为卵巢肿瘤育龄患者提供临床循证医学支持和决策参考。

With the increasing incidence of ovarian tumors among younger women, fertility-sparing surgery (FSS) has emerged as a strategy to balance oncologic control and fertility preservation. Ovarian tumors include borderline ovarian tumors (BOT), early-stage epithelial ovarian cancer (EOC), and non-epithelial ovarian cancer (NEOC). For BOT patients in childbearing age, unilateral salpingo-oophorectomy or cystectomy preserves fertility without significantly increasing recurrence risk. In early-stage EOC, especially International Federation of Obstetrics and Gynecology (FIGO) stage Ⅰ and well-differentiated EOC patients, FSS yields favorable overall survival (OS) in reproductive-aged patients, though certain subtypes, such as high-grade endometrioid carcinoma, may carry poorer prognosis. In NEOC patients with germ cell tumors and sex cord-stromal tumors meeting FSS indications, outcomes are favorable compared to non-FSS treatments. Assisted reproductive technology (ART), including oocyte, embryo, and ovarian tissue cryopreservation, offer additional fertility options. When applied to properly selected ovarian cancer patients, FSS is safe, feasible, and effective. However, challenges remain in indication criteria, surgical choice, long-term prognosis, and integration with ART. This review summarizes current evidence on FSS safety and fertility outcomes in childbearing age patients with BOT, early-stage EOC, and NEOC, aiming to provide clinical decision-making support and evidence-based guidance for fertility preservation in reproductive-aged patients.