[A new method of ovarian transfer in patients with cervical cancer]

As a general treatment for women with invasive carcinoma of the cervix with pelvic lymph node metastasis and/or invasion into the cardinal ligament, a radical operation has been necessary followed by pelvic radiation. However, the irradiation leads to complete cessation of function of ovaries which were retained intact at the radical operation. In order to avoid the influence of irradiation on the ovary, a new operation has been considered; this consists of the transfer of the ovary (1) to the breast or (2) to the lateral upper abdomen. Both sites for transplantation are entirely removed from the pelvic radiation field. The procedure in the former is that the ovary with its own vessels, A. and V. ovarica separated from the retroperitoneum by at least 20 cm, is transferred into the breast through subcutaneous tissue and is followed by fixation into the breast adipose tissue through semicircular incision on areola mammae. In the latter technique, however, a sufficient length of ovarian vessels separated from retroperitoneum is mostly 10 cm or less in order to transfer the ovary to the upper lateral abdomen and fix it on the fascia of this site. A total of 51 patients, in which the age ranged from 24 to 45 years old, have received the ovarian transfer at the radical operation; 31 patients by the former technique and 20 by the latter. After the operation, angiography showed that the circulation of the transplanted ovary was sufficient. Monthly cyclic change in size of the transplanted ovary (CCOS) was evident after operation. This change was related to BBT and levels of serum hormones (FSH, LH, E2 and P4). The frequency of occurrence of the evident CCOS was 20 out of 27 cases (74%) in the former technique and 18 out of 18 (100%) in the latter technique. Radiation doses measured on both the transplanted locations at pelvic irradiation were low enough to avoid disfunction in the transplanted ovary.