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Mitigating the Risk: The Role of Ovarian Transposition and Medical Suppression

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Oncofertility Medical Practice

Abstract

While much of the focus within oncofertility is on fertility preservation options that are performed prior to initiation of cancer treatment, there are two fertility preservation measures that can be performed during treatment in an attempt to reduce the gonadotoxicity of radiation therapy and chemotherapy. For women who must undergo pelvic radiation therapy, ovarian transposition, also called oophoropexy, can be used to surgically reposition the ovaries away from the planned field of radiation. Medical suppression of the ovary with gonadotropin-releasing hormone (GnRH) agonists, given concurrent with chemotherapy, is thought to have a protective effect on the ovary and follicles, though the mechanisms and clinical efficacy of this approach remain unproven and controversial. This chapter describes each of these procedures and reviews the clinical data on their use in patients wishing to preserve their fertility.

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Acknowledgments

The authors would like to thank Dr. Bhavana Pothuri, a gynecologic oncologist at NYU Langone Medical Center, for her critique and expertise related to ovarian transposition and GnRH agonist cotreatment in the setting of cancer. This work was supported by the Oncofertility Consortium NIH/NICHD 5UL1DE019587.

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Authors and Affiliations

  1. Division of Reproductive Endocrinology, New York University School of Medicine, 164 East 72 Street, Apt 15C, New York, NY, 10021, USA

    Jaime M. Knopman M.D. & Nicole Noyes M.D. (Professor)

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  1. Jaime M. Knopman M.D.
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  2. Nicole Noyes M.D.
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Correspondence to Nicole Noyes M.D. .

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Editors and Affiliations

  1. Perelman School of Medicine, Obstetrics and Gynecology, University of Pennsylvania, Market St 3701, Philadelphia, 19104, Pennsylvania, USA

    Clarisa Gracia

  2. Northwestern University, Obstetrics and Gynecology, Feinberg School of Medicine, E Superior St 303, Chicago, 60611-3015, Illinois, USA

    Teresa K Woodruff

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Knopman, J.M., Noyes, N. (2012). Mitigating the Risk: The Role of Ovarian Transposition and Medical Suppression. In: Gracia, C., Woodruff, T. (eds) Oncofertility Medical Practice. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-9425-7_7

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  • DOI: https://doi.org/10.1007/978-1-4419-9425-7_7

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