A new procedure involving the permanent placement of a section (cortical strip) from a patient’s ovaries into her forearm may preserve fertility and normal ovarian function in pre-menopausal women who are treated with radiation to the pelvic area or undergo the removal of their ovaries, according to preliminary results recently published in the Journal of the American Medical Association.
Many types of cancer involve organs or lymph nodes in or near the pelvic area. One common form of treatment for these various cancers involves radiation therapy to the involved region. Due to the anatomical placement of a female patient’s ovaries, radiation directed at the pelvis invariably involves the ovaries and commonly results in infertility and loss of ovarian function. In addition, treatment of other medical conditions may include the removal of a patient’s ovaries (oophorectomy). Since ovaries are responsible for the production of many female hormones, results of pelvic radiation or oophorectomy causes a woman to enter menopause prematurely and become sterile. Since cancers may commonly affect females of reproductive age, menopausal symptoms and sterility can be devastating side effects of treatment for these patients.
Physicians have been evaluating novel treatment approaches in order to preserve ovarian function and child-bearing capabilities in pre-menopausal women who must undergo pelvic radiation or an oophorectomy for the treatment of a disease. Recently, researchers have evaluated a surgical ovarian transplant procedure in two women that has only been previously investigated in laboratory subjects. One woman (35) had advanced cervical cancer and was to undergo pelvic radiation. The second patient (37) had benign cysts on her ovaries and was to undergo an oophorectomy. Both patients had cortical strips removed from their ovaries and permanently transplanted to the forearm. The first patient received her transplant prior to radiation and the second patient received her transplant during the oophorectomy. Ten weeks following surgery, the transplant tissue in both patient’s forearms had resumed the production of ovarian hormones and the development of follicles (eggs). One patient has actually ovulated and the other patient is producing cyclical hormone levels indicative of ovulation. Besides normal hormonal function, the other end goal of this procedure is to be able to harvest eggs from the transplanted ovarian strips so that pre-menopausal patients having to undergo treatment that normally causes sterility can bear children.
Patients who must undergo pelvic radiation therapy or the removal of their ovaries due to various medical conditions including cancer may wish to speak with their physician about this transplant procedure in order to preserve ovarian functioning. (Journal of the American Medical Association, Vol 286, No 12, pp 1490-1493, 2001)
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