Underuse of ovarian transposition in reproductive‐aged cancer patients treated by primary or adjuvant pelvic irradiation

Abstract

Although OT could be a preventive measure of premature ovarian failure from radiation therapy, this procedure has been considerably underused at our institution. This procedure should be applied more widely to preserve the fertility and improve the quality of life in reproductive-aged cancer patients.

Use of Titanium Spiral Tacks for Long-term Oophoropexy Before Pelvic Irradiation

“…Preservation of ovarian function after transposition followed by irradiation is not always successful, with premature menopausal symptoms and menopausal hormonal profiles reported in up to 50% of patients, 4,14,25,26 as in our cohort. Better results have been reported by some authors 27,28 depending mainly on patients' ages: the younger the patient, the better the chance of preserving ovarian function by transposition.…”

“…Ovarian transposition is underused by gynecological oncologists in some institutions, with a rate of only 40% in eligible young patients with cancer. 4,29,30 Ovarian fixation with TsT is a simple, ultraquick method, feasible in both laparoscopic and open surgery and with comparable efficacy with that obtained by suturing. The technique comparability with other fixation techniques requires conformation in larger series.…”

Successful Delivery in a 39-Year-Old Patient with Anal Cancer after Fertility-Preserving Surgery Followed by Primary Chemoradiation and Low Anti-Mullerian Hormone Level

“…Success of ovarian transposition mainly depends on the surgeon's skill (level of transposition) as well as the patient's age [7]. However, this procedure is unfortunately underused [8]. In our patient, additionally uterus fixation to the ventral abdominal wall was performed in order to spare as much as possible of the endometrium from radiation.…”

Fertility Preservation in Reproductive-Age Women Facing Gonadotoxic Treatments

“…The harmful effects of radiation on the ovaries can be minimized by ovarian transposition, a procedure in which the ovaries are surgically transposed to a location outside the radiation field 147 . Transposition can also be combined with gonadal shielding to further reduce the dose effect 148 .…”