Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 3 , Pages 300-304, September 2008

Preservation of Ovarian Germinal Follicles by Temporary Laparoscopic Ovarian Transposition in Teenaged Girls Undergoing Craniospinal Irradiation for Radiosensitive Central Nervous System Tumors

  • Fu-Tsai Kung

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung University College of Medicine, Kaohsiung, Taiwan
    • ,
  • Hui-Chun Chen

      Affiliations

    • Department of Radiation Oncology, Chang Gung University College of Medicine, Kaohsiung, Taiwan
    • ,
  • Chao-Cheng Huang

      Affiliations

    • Department of Pathology, Chang Gung University College of Medicine, Kaohsiung, Taiwan
    • ,
  • Jih Tsun Ho

      Affiliations

    • Department of Neurosurgery, Chang Gung Memorial Hospital—Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
    • ,
  • Bi-Hua Cheng

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung University College of Medicine, Kaohsiung, Taiwan
    • Department of Graduate Institute of Medical Science, Chang Gung University, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Bi-Hua Cheng, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital—Kaohsiung Medical Center, 123, Ta Pei Road, Niao Sung Hsiang, Kaohsiung 833, Taiwan

Accepted 18 January 2008.

Article Outline

Summary 

Objective

To report the efficacy of laparoscopic ovarian transposition procedure in teenaged girls for preventing ovarian damage from craniospinal radiation therapy.

Materials and Methods

Five teenaged girls were diagnosed with radiosensitive brain germinomas or medulloblastomas that needed irradiation with doses of higher than 500 cGy to the whole craniospinal area after craniotomy. The oophoropexy method was lateral transposition of the ovaries to the round ligament without opening the surrounding peritoneum so as to move the ovaries outside of the radiation field. Meanwhile, the hemoclip was clamped on the medial site of the ovary to guide the radiologist to set a proper field between the two ovaries for radiation therapy. After irradiation with the total dose completed, second-look laparoscopy was performed to remove the Prolene stitches and hemoclips. Bilateral ovarian biopsies were performed to evaluate the efficacy on the preservation of ovarian tissue, upon the consent of each patient and her parents.

Results

On second-look laparoscopy, only small amounts of loose adhesions surrounding the hemoclips and ties were found. Histologic measurements showed that there were more than 10 germinal follicles per high-power field in each ovarian tissue section.

Conclusion

Laparoscopic oophoropexy is an easy and safe surgical procedure for teenaged girls. It can be used to successfully prevent craniospinal irradiation damage to the ovarian germinal follicles in teenaged girls and to retain their ovarian reproductive function.

Key Words:  germinal follicle , germinoma , laparoscopy oophoropexy , medulloblastoma , ovarian transposition , radiotherapy

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References 

  1. Haie-Meder C , Mlika-Cabanne N , Michel G , et al.   Radiotherapy after ovarian transposition: ovarian function and fertility preservation . Int J Radiat Oncol Biol Phys . 1993;25:419–424
  2. Morice P , Thiam-Ba R , Castaigne D , et al.   Fertility results after ovarian transposition for pelvic malignancies treated by external irradiation or brachytherapy . Hum Reprod . 1998;13:660–663
  3. Kung FT , Hwang FR , Lin H , Tai MC , Hsieh CH , Chang SY . Comparison of laparoscopically assisted vaginal hysterectomy and abdominal hysterectomy in Taiwan . J Formos Med Assoc . 1996;95:769–775
  4. Treissman MJ , Miller D , McComb PF . Laparoscopic lateral ovarian transposition . Fertil Steril . 1996;65:1229–1231
  5. Tulandi T , Al-Took S . Laparoscopic ovarian suspension before irradiation . Fertil Steril . 1998;70:381–383
  6. Sklar CA , Constine LS . Chronic neuroendocrinological sequelae of radiation therapy . Int J Radiat Oncol Biol Phys . 1995;31:1113–1121
  7. Vital VS , Tellez S , Alvaarado I , Hinojosa C , Reyes A . Clinical histologic correlation in reproductive pathology . Obstet Gynecol . 2000;95:S83
  8. Anderson B , LaPolla J , Turner D , Chapman G , Buller R . Ovarian transposition in cervical cancer . Gynecol Oncol . 1993;49:206–214
  9. Lee CL , Lai YM , Soong YK , Lin TK , Tang SG . Laparoscopic ovariopexy before irradiation for medulloblastoma . Hum Reprod . 1995;10:372–374

PII: S1028-4559(08)60128-X

doi:10.1016/S1028-4559(08)60128-X

Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 3 , Pages 300-304, September 2008

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