Ovarian transposition in young patients with invasive cervical cancer receiving radiation therapy

Twenty-two patients with invasive cervical cancer had ovarian transposition. Fifteen patients received whole pelvic external radiation therapy via a teletherapy unit, and nine patients also received one or two intracavitary insertions. Ovarian function was measured by serum gonadotropins, FSH, and LH. We were unable to measure gonadotropin levels in four patients because they were lost to follow-up after completion of radiation therapy. Five patients developed postmenopausal symptoms; in two the ovaries were not shielded and they received radiation by lateral ports with an average dose above 2500 cGY. Therefore, ovarian function was preserved in seven of 11 patients (64%), all of whom received 500 cGY with an average dose of 250 cGY to the ovaries via external radiation and intracavitary insertion(s). FSH values ranged from 3.3 to 38.8 mlU ml⁻¹ (mean = 17.7 mlU ml⁻¹). Two patients developed symptomatic ovarian cysts. Ovarian function can be preserved by transposing the ovaries at the time of surgery prior to radiation with adequate treatment planning which limits the radiation dose to the ovaries to 300 cGY.