Do you offer ovarian transposition to premenopausal cervical cancer patients prior to chemoradiation therapy?

Ovarian transposition or oophoropexy is definitely something to consider in premenopausal patients prior to chemoradiation for cervical cancer. Ovarian function is sensitive to radiation with as little as 2Gy leading to permanent ovarian insufficiency via follicular loss, limiting follicular maturation, or leading to physical damage of the ovarian cortex or capsule (ACOG committee opinion 747, PMID: 30045213). It is important to note that ovarian insufficiency is related to the patient’s pre-tre...

As most patients with ovarian cancer are young and premenopausal, preservation of the ovarian function is always a consideration. It is important to preserve hormonal function to prevent osteoporosis, CAD, dyslipidemia, preserve life expectancy, and quality of life.

In my practice, I offer ovarian transposition with oophoropexy to patients under the age of 45, with squamous histology and < stage IB1. As part of my counseling, I discuss ~40% risk of ovarian failure after radiation despite the tra...