What techniques do you use to address fertility preservation in young female patients being treated with chemoradiation therapy for cancer in the pelvis?

The most important aspect of a fertility preservation strategy is to think of it early on in the discussions with your patient. Many medical centers now have a clinic or center to which patients can be referred and seen within several days. They are experts at explaining the options and outcomes with a number of strategies. Some of these strategies do require time, as egg retrieval will require a period of hormonal stimulation. Egg freezing or embryo formation can follow depending upon the presence of a partner for sperm donation and fertilization. Positioning of the ovaries up and away from the pelvis can be done with laparoscopy, but sometimes the manipulation itself can lead to ovarian failure, so it is important to discuss this risk wit...

For chemo RT to pelvis like in cervical ca, we usually cryopreseve one ovary, and move the other to high up in the paracolic gutter and try to restrict RT dose.

First line for fertility preservation for a patient who is post-menarcheal is oocyte cryopreservation. Many reproductive endocrinologists are now using a quicker method for harvesting, and the medication costs can be covered with help from nonprofit organizations like Livestrong.org (https://www.livestrong.org/we-can-help/livestrong-fertility). Other methods (i.e. Lupron, repositioning of the ovaries) have not been proven to be successful.

It is important to find a reproductive endocrinologist who is familiar with this procedure to help with getting the procedure done quickly, prior to treatments. Our go-to REI in Phoenix will see the patients the next day, and works closely with the family to help with the costs. He usually is able to perf...

I agree with all excellent recommendations above from Drs. @Dr. First Last, @Dr. First Last, and @Dr. First Last. Another option is to use proton therapy, particularly scanning beam (Intensity Modulated Proton Therapy) with posterior/oblique angle beam. I treated a few young patients for pelvic malignancies and able to keep the mean dose to ovary to < 2 to 3 Gy.

See attached image.

Discussed here in an abstract in the Red Journal

Proton Therapy for Sparing Fertility in Girls Requiring Craniospinal Irradiation: Is There a Role for Ooophoropexy?