A groundbreaking surgical procedure is offering renewed hope for women facing cancer treatment who wish to preserve their fertility. Specifically, the technique provides a potential option for those diagnosed with pelvic tumors, such as rectal or colon cancer, requiring radiation therapy.
Radiation therapy and chemotherapy, while effective in eliminating cancer cells, can cause significant damage to the uterus and ovaries. To address this, surgeons are now exploring the possibility of temporarily relocating the uterus and ovaries outside of the radiation field during cancer treatment, and then returning them to their original position once treatment is complete.
This approach is translating into successful outcomes. Recently, a medical team in Switzerland announced the birth of a healthy baby boy, Lucien, to a woman who underwent this procedure. Daniela Huber, MD, a gynecologic oncologist who performed the surgery, explained that this baby represents the fifth child born following this surgical intervention, and the first such case in Europe. Reitan Ribeiro, MD, the gynecologic oncologist who initially pioneered the technique, added that at least three more babies have been born using this method since then. Both physicians shared details of the surgical process and its results.
Dr. Huber’s patient was a 28-year-old woman diagnosed with a tumor approximately 4 centimeters in diameter in her rectum. The medical team at Sion Hospital in Switzerland recommended a combination of chemotherapy and radiation therapy to shrink the tumor before surgical removal.
The procedure, known as uterine and ovarian transposition, involves carefully dissecting and repositioning the uterus and ovaries. As described in a report from Memorial Sloan Kettering Cancer Center, the surgical technique is similar to a traditional hysterectomy, but with a crucial difference: instead of removing the uterus, It’s meticulously preserved and repositioned. A key focus during the surgery is to avoid damaging the blood supply to the uterus, particularly the infundibulopelvic ligament, ensuring its continued viability and reproductive potential.
The concept behind this approach isn’t entirely new. Fertility-sparing options for cancer patients have been explored for some time. According to UT Southwestern Medical Center, a cancer diagnosis doesn’t automatically equate to infertility, and various preservation options may be available depending on the cancer type. However, a 2015 study in Cancer highlighted that women often don’t receive sufficient information about these options before beginning treatment. Despite 70% of participants knowing their treatment could impact fertility, only 6.8% utilized fertility-preserving methods.
The uterine transposition procedure aims to address this gap by offering a proactive solution. By moving the reproductive organs outside the radiation field, the risk of radiation-induced infertility is minimized. This is particularly important for younger patients who haven’t yet completed their families. As Dr. Carla Hajj, a radiation oncologist at Memorial Sloan Kettering Cancer Center, explained in the case of Dana Vergara, a patient who successfully delivered a baby after undergoing the procedure, radiation to the pelvis can damage the uterus and potentially lead to premature menopause.
The success of Dana Vergara, who was the first person in the U.S. To deliver a baby after uterine transposition surgery, and the recent birth of Lucien in Switzerland, demonstrate the potential of this innovative technique. While uterine transposition is not a suitable option for all patients, it represents a significant advancement in fertility preservation for women facing cancer treatment. The procedure offers a valuable option for women seeking to balance the need for effective cancer treatment with their desire to have children.
The procedure is not without its complexities. It requires a skilled surgical team and careful patient selection. Further research and long-term follow-up are needed to fully understand the potential risks and benefits of uterine transposition. However, the early results are encouraging, offering a beacon of hope for women facing a challenging diagnosis.
As highlighted by Baptist Health, uterine transposition is a promising solution for female patients with pelvic tumors who require radiation therapy but wish to preserve their fertility. The careful relocation of the uterus minimizes the risk of radiation-induced infertility, allowing women to potentially pursue future pregnancies.
