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Fertility preservation in women with recurrent serous borderline ovarian tumors (SBOTs) remains clinically challenging because of concerns regarding oncological safety and limited evidence. We report the case of a young woman with FIGO Stage IIIA1 SBOT with lymph node involvement who experienced multiple recurrences with adverse pathological features, including micropapillary architecture and stromal microinvasion. Following multidisciplinary discussion and comprehensive counseling, a brief micro-stimulation in vitro fertilization protocol was performed for embryo cryopreservation prior to repeat fertility-sparing surgery to minimize treatment delay. After complete macroscopic disease clearance, frozen-thawed embryo transfer was carried out, resulting in a successful term live birth. No clinical or radiological evidence of recurrence was observed during the available follow-up period. This case suggests that an individualized fertility-first strategy may be considered in carefully selected patients with advanced recurrent SBOT under strict multidisciplinary evaluation and close surveillance.