Oophoropexy: a relevant role in preservation of ovarian function after pelvic irradiation

Fertil Steril. 2009 Mar;91(3):935.e15-6. doi: 10.1016/j.fertnstert.2008.09.029. Epub 2008 Oct 31.

Abstract

Objective: To report on our experience with girls and young women who received treatment for Hodgkin lymphoma, underwent prior oophoropexy to preserve their ovarian function, and subsequently gave birth.

Design: Retrospective monoinstitutional evaluation.

Setting: National Cancer Institute.

Patient(s): Eleven girls given treatment for Hodgkin lymphoma and undergoing bilateral ovarian transposition at a median age of 13 years.

Intervention(s): The ovaries were positioned behind the uterus by the general surgeon.

Main outcome measure(s): Fourteen pregnancies were recorded among these 11 women, with 12 live births (1 twin) and 3 miscarriages.

Result(s): None of these women needed the ovaries to be relocated, and none of them resorted to artificial insemination. Their median age at the time of first pregnancy was 31 years, and the median time elapsing since ovarian transposition was 14 years.

Conclusion(s): This series confirms that oophoropexy can preserve ovarian function and enable future pregnancy. We encourage pediatric oncologists, surgeons, and radiotherapists to bear this option in mind when considering female patients for pelvic irradiation.

MeSH terms

  • Abortion, Spontaneous
  • Adolescent
  • Adult
  • Child
  • Female
  • Gynecologic Surgical Procedures*
  • Hodgkin Disease / radiotherapy*
  • Humans
  • Infertility, Female / etiology
  • Infertility, Female / prevention & control*
  • Laparoscopy*
  • Live Birth
  • Ovary / surgery*
  • Pelvis
  • Pregnancy
  • Pregnancy Rate
  • Radiation Injuries / etiology
  • Radiation Injuries / prevention & control*
  • Radiotherapy / adverse effects
  • Retrospective Studies
  • Young Adult