When radiotherapy is indicated, it is sometimes possible to surgically reposition the ovaries higher in the abdomen so that they are completely outside of the radiation field, Dr McKenzie said. Oocyte and embryo cryopreservation are also widely available.3
Brachytherapy poses a lower risk to fertility but it is rarely used alone.
“This is not part of any current standard of care,” Dr McKenzie explained. Her group is developing an adjuvant radiotherapy strategy specifically for women who wish to undergo fertility-sparing surgery, but details are not yet available.
1. McKenzie ND, Kennard JA, Ahmad S. Fertility preserving options for gynecologic malignancies: A review of current understanding and future directions. Crit Rev Oncol Hematol. 2018;132:116-124.
2. Gerstl B, Sullivan E, Chong S, Chia D, Wand H, Anazodo A. Reproductive outcomes after a childhood and young adolescent young adult cancer diagnosis in female cancer survivors: a systematic review and meta-analysis [published online December 5, 2018]. J Adolesc Young Adult Oncol. doi:10.1089/jayao.2018.0036
3. Oktay K, Harvey BE, Partridge AH, et al. Fertility preservation in patients with cancer: ASCO Clinical Practice Guideline update. J Clin Oncol. 2018;36(19):1994-2001.