Human Reproduction, Vol 13, 660-663, Copyright © 1998 by Oxford University Press
P Morice, R Thiam-Ba, D Castaigne, C Haie-Meder, A Gerbaulet, P Pautier, P Duvillard and G Michel
The aim of this study was to assess the fertility outcome after ovarian
transposition with uterine conservation and pelvic irradiation therapy for
pelvic cancer. A total of 37 consecutive cases were reviewed. Of these, 27
patients were treated for a clear cell adenocarcinoma of the vagina and/or
the cervix (group 1), nine for an ovarian pure dysgerminoma and one for a
para-uterine soft tissue sarcoma (group 2). The pregnancy rate was 15%
(4/27) in group 1 and 80% (8/10) in group 2 (P=0.01). A total of 18
pregnancies was observed in 12 patients. Of these, 16 pregnancies were
obtained spontaneously and two after in- vitro fertilization. Of the
spontaneous pregnancies, 12 (75%) were observed with ovaries still in the
abdominal cavity (not repositioned). These results show that the prognosis
for fertility is excellent after ovarian transposition and irradiation in
patients with morphologically normal genital tracts (group 2). The
prognosis is not as good for patients treated for a clear cell
adenocarcinoma of the vagina and/or the cervix who may have morphological
and/ or functional anomalies of the genital tract, following exposure to
diethylstilboestrol and brachytherapy (group 1). Furthermore, these results
show that repositioning of the ovary is not essential to achieve pregnancy.
ARTICLES
Fertility results after ovarian transposition for pelvic malignancies treated by external irradiation or brachytherapy
Service de Chirurgie Gynecologique, Institut Gustave Roussy, Villejuif, France.
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