USNews.com: Health: In Brief: Pregnancy, Infertility, and Infants: Fertility preservation

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Friday, November 21, 2008

Fertility preservation

Cervical cancer patient has ovary moved to upper arm

By Helen Fields

1/11/05

When young women have cervical cancer, the radiation therapy after surgery can make them infertile. One way to deal with this is to cut out an ovary and transplant it to somewhere else in the body, where the radiation will miss it. Doctors in the Netherlands tried this on a 29-year-old woman from the former Dutch colony of Suriname, on the northeast coast of South America.

What the researchers wanted to know: Can a woman's fertility be preserved through cervical cancer treatment?

What they did: The woman, who'd had two children, was referred to the Leiden University Medical Center with cervical cancer in January, 2002. The woman agreed to have her left ovary transplanted to the left upper arm. In the operating room, one team worked on her abdomen, removing her left ovary and shifting her right ovary to her upper abdomen, outside of the area where radiation would normally be aimed. They also performed a radical hysterectomy. A second surgical team opened her left upper arm, attaching the ovary's incoming artery and outgoing vein to an artery and vein in the arm. Because her tumor was fairly large and the cancer had spread to the vagina, doctors recommended radiation therapy to the patient. But she was very homesick by then and decided to go back to Suriname instead.

What they found: A few days after the operation, ultrasound showed that the transplanted ovary was getting plenty of blood. The last time doctors examined her ovary, before submitting the article in June 2004, it looked fine and seemed to be behaving normally—the woman's arm swelled cyclically. But, because cancer had reappeared in her lower abdomen about a year after the surgery, they didn't try to extract any oocytes.

What the study means to you: This could be a workable option for preserving ovaries—and thus avoiding early menopause—in women who have to undergo a hysterectomy and radiation treatment. There is a very small risk that a transplanted ovary could bring metastatic cancer cells along with it.

Caveats: Because the woman refused radiation therapy, the doctors didn't actually get to see how the ovary did in those conditions.

Find out more: Sexuality for women after cancer, from the Mayo Clinic

Cervical cancer, from the National Cancer Institute

Read the article: Hilders, C.G., et al. "Successful Human Ovarian Autotransplantation to the Upper Arm." Cancer. Dec. 15, 2004, Vol. 101, No. 12, pp. 2771-2778.

Abstract online: www3.interscience.wiley.com

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