medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-3-28-32medsovet-6068Research ArticleРЕПРОДУКТИВНОЕ ЗДОРОВЬЕ И ВРТREPRODUCTIVE HEALTH AND ARTТактика сохранения репродуктивного материала при раке шейки матки. Репродуктивное здоровье и ВРТA challenge of fertility preservation in the setting of cervical cancer - a clinical casehttps://orcid.org/0000-0001-5119-3816ДмитриеваИ. Е.DmitrievaI. E.

Дмитриева Ирина Евгеньевна – аспирант.

117997, Москва, ул. Академика Опарина, д. 4

Irina E. Dmitrieva - Gaduate Student.

4, Academician Oparin St., Moscow, 117997

nika06@inbox.ruhttps://orcid.org/0000-0002-9304-4410МартиросянЯ. О.MartirosyanY. O.

Мартиросян Яна Ованнесовна - младший научный сотрудник Научно-образовательного центра вспомогательных репродуктивных технологий с клиническим отделением имени Фредерика Паулсена.

117997, Москва, ул. Академика Опарина, д. 4

Yana O. Martirosyan - Junior Researcher of the Institute of Reproductive Medicine.

4, Academician Oparin St., Moscow, 117997

ya_martirosyan@oparina4.ruhttps://orcid.org/0000-0002-2891-3974ДжанашвилиЛ. Г.DzhanashviliL. G.

Джанашвили Лана Георгиевна – аспирант.

117997, Москва, ул. Академика Опарина, д. 4

Lana G. Dzhanashvili - Gaduate Student, Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology

ana.janashvili@gmail.comhttps://orcid.org/0000-0001-9850-7982ДементьеваВ. О.DementyevaV. O.

Дементьева Виктория Олеговна - аспирант отделения оперативной гинекологии.

117997, Москва, ул. Академика Опарина, д. 4

Victoria O. Dementyeva - Postgraduate Student of the Department of Operative Gynecology.

4, Academician Oparin St., Moscow, 117997

victoriadementyeva93@gmail.comhttps://orcid.org/0000-0002-3253-4512АдамянЛ. В.AdamyanL. V.

Адамян Лейла Вагоевна - академик РАН, доктор медицинских наук, профессор, заместитель директора по научной работе, руководитель отделения оперативной гинекологии, НМИЦАГП имени академика В.И. Кулакова; заведующая кафедрой репродуктивной медицины и хирургии факультета дополнительного профессионального образования, МГМСУ имени А.И. Евдокимова; SPIN: 9836-2713.

117997, Москва, ул. Академика Опарина, д. 4; 127473, Москва, ул. Делегатская, д. 20, стр. 1

Leila V. Adamyan - Academician of RAS, Dr. Sci. (Med.), Professor, Deputy Director for Research, Head of the Operative Gynecology Department, Kulakov NMRCOGP; Head of the Department of Reproductive Medicine and Surgery of the Faculty of Postgraduate Education, Yevdokimov MSUMD.

4, Academician Oparin St., Moscow, 117997; 20, Bldg. 1, Delegateskaya St., Moscow, 127473

adamyanleila@gmail.comhttps://orcid.org/0000-0002-5823-1667НазаренкоТ. А.NazarenkoT. A.

Назаренко Татьяна Алексеевна - доктор медицинских наук, профессор, директор Института репродуктивной медицины, НМИЦАГП имени академика В.И. Кулакова; заместитель генерального директора по лечебной и научной работе, Клиника профессора В.М. Здановского;

117997, Москва, ул. Академика Опарина, д. 4; 115191, Москва, Холодильный пер., д. 2, стр. 2

Tatyana A. Nazarenko, Dr. Sci. (Med.), Professor, Head of the Institute of Reproductive Medicine, Kulakov NMRCOGP; Deputy General Director for Medical and Scientific Work, Zdanovsky Clinic;

4, Academician Oparin St., Moscow, 117997; 2, Kholodilny Lane, Moscow, 115191

t_nazarenko@oparina4.ruНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика В.И. КулаковаРоссияKulakov National Medical Research Center of Obstetrics, Gynecology and PerinatologyRussian FederationНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика В.И. КулаковаRussian FederationНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика В.И. Кулакова; Московский государственный медико-стоматологический университет им. А.И. ЕвдокимоваРоссияKulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology; Yevdokimov Moscow State University of Medicine and DentistryRussian FederationНациональный медицинский исследовательский центр акушерства, гинекологии и перинатологии им. академика В.И. Кулакова; Клиника профессора В.М. ЗдановскогоРоссияKulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology; Zdanovsky ClinicRussian Federation202114042021032832Copyright © Дмитриева И.Е., Мартиросян Я.О., Джанашвили Л.Г., Дементьева В.О., Адамян Л.В., Назаренко Т.А., 20212021Дмитриева И.Е., Мартиросян Я.О., Джанашвили Л.Г., Дементьева В.О., Адамян Л.В., Назаренко Т.А.Dmitrieva I.E., Martirosyan Y.O., Dzhanashvili L.G., Dementyeva V.O., Adamyan L.V., Nazarenko T.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6068

Вопрос сохранения репродуктивной функции у пациенток, больных раком шейки матки, приобретает все большую значимость в условиях современных возможностей ранней диагностики и лечения. Для пациенток с диагностированным раком шейки матки разработаны различные методы с установленной эффективностью - от транспозиции яичников до криоконсервации ооцитов, эмбрионов и тканей яичника. Тем не менее приоритетность и порядок действий при обращении таких пациенток остаются неясными, из-за чего возникают сложности с определением тактики лечения.

В данной статье представлен клинический случай сохранения репродуктивного материала у молодой пациентки, перенесшей транспозицию яичников. Обсуждаются особенности проведения у таких пациенток контролируемой овариальной стимуляции и забора ооцитов, а также результативность данных процедур в сравнении с проведением аналогичного лечения до транспозиции. В данном случае у пациентки с транспонированными яичниками в результате проведения КОС было получено 3 ооцита (против 20 у пациентки со сходным клиническим и гинекологическим анамнезом, но до проведения транспозиции яичников). Учитывая особенности, затрудняющие получение репродуктивного материала после транспозиции яичников, мы рекомендуем рассматривать возможность проведения криоконсервации ооцитов или эмбрионов до проведения транспозиции у пациенток, больных раком шейки матки. При наличии достаточного времени до лечения основного заболевания данная тактика может повысить эффективность сохранения репродуктивного материала и улучшить перспективы получения генетического потомства в будущем, после лечения основного заболевания.

The issue of fertility preservation in patients with cervical cancer is getting more and more common considering the improved effectiveness of early diagnosis and treatment of cancer. There is a number of evidence-based tactics available to the patients with diagnosed cervical cancer. These tactics have been proved effective and include methods such as ovarian transposition; oocyte, embryo and ovarian tissue cryopreservation. Nonetheless, there are no existing medical algorithms to define the priority of actions that should be taken in such cases of restricted time. The objective of this clinical case report is to highlight an existing concern towards the decision-making process regarding fertility preservation in patients with cervical cancer.

In this paper we report a clinical case of fertility preservation tactics in a patient undergone ovarian transposition. We pay attention to particular features of the controlled ovarian stimulation (COS) and oocyte retrieval process typical for such patients. The article discusses the subject of COS and oocyte retrieval effectiveness compared to patients who did not undergo ovarian transposition. The 35-year old patient presented 9 month after ovarian transposition to perform oocyte cryopreservation. As a result of COS 3 oocytes were aspirated, compared to 20 oocytes in another patient of comparable age and medical history, but with no ovarian transposition performed.

Regarding particular conditions constraining ovarian stimulation and oocyte retrieval after ovarian transposition, we recommend to consider the possibility of performing oocyte/embryo cryopreservation before ovarian transposition in patients with cervical cancer. Prioritizing oocyte and embryo cryopreservation in case of having sufficient time before treatment could significantly improve possibilities of achieving genetically related offspring in a long-term perspective.

онкофертильностьтранспозиция яичниковкриоконсервация репродуктивного материаларак шейки маткилучевая терапиятрансабдоминальная пункция яичниковoncofertilityovarian transpositionfertility preservationcervical cancerradiotherapytransabdominal follicular aspirationReferencesArbyn M., Weiderpass E., Bruni L., de Sanjose S., Saraiya M., Ferlay J., Bray F. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 2020;8(2):e191-e203. doi: 10.1016/S2214-109X(19)30482-6.Arbyn M., Weiderpass E., Bruni L., de Sanjose S., Saraiya M., Ferlay J., Bray F. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 2020;8(2):e191-e203. doi: 10.1016/S2214-109X(19)30482-6.Ашрафян Л.А., Новикова Е.Г., Тюляндина А.С., Урманчеева А.Ф., Берлев И.В., Антонова И.Б. и др. Рак шейки матки: клинические рекомендации. М.; 2020. Режим доступа: https://endoexpert.ru/dokumenty-i-prikazy/utver-zhdennye-klinicheskie-rekomendatsii-rak-sheyki-matki-deystvushchie-2020-g/.Ashrafyan L.A., Novikova E.G., Tyulyandina A.S., Urmancheeva A.F., Berlev I.V., Antonova I.B. et al Cervical cancer: clinical guidelines. Moscow; 2020. (In Russ.) Available at: https//endoexpert.ru/dokumenty-i-prikazy/utverzh-dennye-klinicheskie-rekomendatsii-rak-sheyki-matki-deystvushchie-2020-g/Каприн А.Д., Старинский В.В., Шахзадова А.О. (ред.). Состояние онкологической помощи населению России в 2019 году. М.: МНИОИ им. ПА. Герцена - филиал ФГБУ «НМИЦ радиологии» Минздрава России; 2020. Режим доступа: https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiZidSfhpDuAhXu_CoKHZJUALIOFjAAegOIBBAC&url=https%3A%2F%2Fglavonco.ru%2Fcancer_register%2F%25D0%259F%25D0%25BE%25D0%25BC%25D0%25BE%25D1%2589%25D1%258C%25202019.pdf&usg=AOvVaw0Cics49SfOKKGOSMTDHE2m.Kaprin A.D., Starinsky V.V., Shakhzadova A.O. The state of cancer care for the population of Russia in 2019. Мoscow: Hertzen Moscow Oncology Research Institute - branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation; 2020. 239 p. (In Russ.) Available at: https//www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwiZidSfhpDuAhXu_CoKHZJUALIOFjAAegOIBBAC&url=https%3A%2F%2Fglavonco.ru%2Fcancer_register%2F%25D0%259F%25D0%25BE%25D0%25BC%25D0%25BE%25D1%2589%25D1%258C%25202019.pdf&usg=AOvVaw0Cics49SfOKKGOSMTDHE2m.Logan S., Perz J., Ussher J., Peate M., Anazodo A. Clinician provision of oncofertility support in cancer patients of a reproductive age: A systematic review. Psychooncology. 2018;27(3):748-756. doi: 10.1002/pon.4518.Logan S., Perz J., Ussher J., Peate M., Anazodo A. Clinician provision of oncofertility support in cancer patients of a reproductive age: A systematic review. Psychooncology. 2018;27(3):748-756. doi: 10.1002/pon.4518.Bhatla N., Aoki D., Sharma D.N., Sankaranarayanan R. Cancer of the cervix uteri. Int J Gynaecol Obstet. 2018;143(2 Suppl.):22-36. doi: 10.1002/ijgo.12611.Bhatla N., Aoki D., Sharma D.N., Sankaranarayanan R. Cancer of the cervix uteri. Int J Gynaecol Obstet. 2018;143(2 Suppl.):22-36. doi: 10.1002/ijgo.12611.Wallace W.H., Thomson A.B., Kelsey T.W. The radiosensitivity of the human oocyte. Hum Reprod. 2003;18(1):117-121. doi: 10.1093/humrep/deg016.Wallace W.H., Thomson A.B., Kelsey T.W. The radiosensitivity of the human oocyte. Hum Reprod. 2003;18(1):117-121. doi: 10.1093/humrep/deg016.Wallace W.H., Thomson A.B., Saran F., Kelsey T.W. Predicting age of ovarian failure after radiation to a field that includes the ovaries. Int J Radiat Oncol Biol Phys. 2005;62(3):738-744. doi: 10.1016/j.ijrobp.2004.11.038Wallace W.H., Thomson A.B., Saran F., Kelsey T.W. Predicting age of ovarian failure after radiation to a field that includes the ovaries. Int J Radiat Oncol Biol Phys. 2005;62(3):738-744. doi: 10.1016/j.ijrobp.2004.11.038Wo J.Y., Viswanathan A.N. Impact of radiotherapy on fertility, pregnancy, and neonatal outcomes in female cancer patients. Int J Radiat Oncol Biol Phys. 2009;73(5):1304-1312. doi: 10.1016/j.ijrobp.2008.12.016.Wo J.Y., Viswanathan A.N. Impact of radiotherapy on fertility, pregnancy, and neonatal outcomes in female cancer patients. Int J Radiat Oncol Biol Phys. 2009;73(5):1304-1312. doi: 10.1016/j.ijrobp.2008.12.016.Ghadjar P, Budach V., Kohler C., Jantke A., Marnitz S. Modern radiation therapy and potential fertility preservation strategies in patients with cervical cancer undergoing chemoradiation. Radiat Oncol. 2015;10:50. doi: 10.1186/s13014-015-0353-4.Ghadjar P, Budach V., Kohler C., Jantke A., Marnitz S. Modern radiation therapy and potential fertility preservation strategies in patients with cervical cancer undergoing chemoradiation. Radiat Oncol. 2015;10:50. doi: 10.1186/s13014-015-0353-4.Lv XJ., Cheng X.L., Tu Y.O., Yan D.D., Tang O. Association between the location of transposed ovary and ovarian dose in patients with cervical cancer treated with postoperative pelvic radiotherapy. Radiat Oncol. 2019;14(1):230. doi: 10.1186/s13014-019-1437-3.Lv XJ., Cheng X.L., Tu Y.O., Yan D.D., Tang O. Association between the location of transposed ovary and ovarian dose in patients with cervical cancer treated with postoperative pelvic radiotherapy. Radiat Oncol. 2019;14(1):230. doi: 10.1186/s13014-019-1437-3.McCall M.L., Keaty E.C., Thompson J.D. Conservation of ovarian tissue in the treatment of carcinoma of the cervix with radical surgery. Am J Obstet Gynecol. 1958;75(3):590-600. doi: 10.1016/0002-9378(58)90614-8.McCall M.L., Keaty E.C., Thompson J.D. Conservation of ovarian tissue in the treatment of carcinoma of the cervix with radical surgery. Am J Obstet Gynecol. 1958;75(3):590-600. doi: 10.1016/0002-9378(58)90614-8.Arian S.E., Goodman L., Flyckt R.L., Falcone T. Ovarian transposition: a surgical option for fertility preservation. Fertil Steril. 2017;107(4):e15. doi: 10.1016/j.fertnstert.2017.01.010.Arian S.E., Goodman L., Flyckt R.L., Falcone T. Ovarian transposition: a surgical option for fertility preservation. Fertil Steril. 2017;107(4):e15. doi: 10.1016/j.fertnstert.2017.01.010.Winarto H., Febia E., Purwoto G., Nuranna L. The need for laparoscopic ovarian transposition in young patients with cervical cancer undergoing radiotherapy. Int J Reprod Med. 2013;2013:173568. doi: 10.1155/2013/173568.Winarto H., Febia E., Purwoto G., Nuranna L. The need for laparoscopic ovarian transposition in young patients with cervical cancer undergoing radiotherapy. Int J Reprod Med. 2013;2013:173568. doi: 10.1155/2013/173568.Huang K.G., Lee C.L., Tsai C.S., Han C.M., Hwang L.L. A new approach for laparoscopic ovarian transposition before pelvic irradiation. Gynecol Oncol. 2007;105(1):234-237. doi: 10.1016/j.ygyno.2006.12.001.Huang K.G., Lee C.L., Tsai C.S., Han C.M., Hwang L.L. A new approach for laparoscopic ovarian transposition before pelvic irradiation. Gynecol Oncol. 2007;105(1):234-237. doi: 10.1016/j.ygyno.2006.12.001.Henes M., Engler T., Taran F.A., Brucker S., Rall K., Janz B., Lawrenz B. Ovarian cyst removal influences ovarian reserve dependent on histology, size and type of operation. Womens Health (Lond). 2018;14:1745506518778992. doi: 10.1177/1745506518778992.Henes M., Engler T., Taran F.A., Brucker S., Rall K., Janz B., Lawrenz B. Ovarian cyst removal influences ovarian reserve dependent on histology, size and type of operation. Womens Health (Lond). 2018;14:1745506518778992. doi: 10.1177/1745506518778992.Kalra G.S., Campbell S., Nargund G. Ovarian reserve may be compromised after adnexal surgery: Are we sufficiently fertility-focused in our surgical training? Facts Views Vis Obgyn. 2016;8(2):104-108. Available at: https://pubmed.ncbi.nlm.nih.gov/27909567/.Kalra G.S., Campbell S., Nargund G. Ovarian reserve may be compromised after adnexal surgery: Are we sufficiently fertility-focused in our surgical training? Facts Views Vis Obgyn. 2016;8(2):104-108. Available at: https://pubmed.ncbi.nlm.nih.gov/27909567/.Cho H.Y., Park S.T., Kyung M.S., Park S.H. Assessment of ovarian reserve after hysterectomy: Laparoscopic vs. non-laparoscopic surgery. Eur J Obstet Gynecol Reprod Biol. 2017;210:54-57. doi: 10.1016/j.ejogrb.2016.12.003.Cho H.Y., Park S.T., Kyung M.S., Park S.H. Assessment of ovarian reserve after hysterectomy: Laparoscopic vs. non-laparoscopic surgery. Eur J Obstet Gynecol Reprod Biol. 2017;210:54-57. doi: 10.1016/j.ejogrb.2016.12.003.Turkgeldi L., Cutner A., Turkgeldi E., Cassoni A., Macdonald N., Mould T. et al. Laparoscopic Ovarian Transposition and Ovariopexy for Fertility Preservation in Patients Treated with Pelvic Radiotherapy with or without Chemotherapy. Facts Views Vis Obgyn. 2019;11(3):235-242. Available at: https://pubmed.ncbi.nlm.nih.gov/32082530/.Turkgeldi L., Cutner A., Turkgeldi E., Cassoni A., Macdonald N., Mould T. et al. Laparoscopic Ovarian Transposition and Ovariopexy for Fertility Preservation in Patients Treated with Pelvic Radiotherapy with or without Chemotherapy. Facts Views Vis Obgyn. 2019;11(3):235-242. Available at: https://pubmed.ncbi.nlm.nih.gov/32082530/.Ethics Committee of the American Society for Reproductive Medicine. Fertility preservation and reproduction in patients facing gonadotoxic therapies: an Ethics Committee opinion. Fertil Steril. 2018;110(3):380-386. doi: 10.1016/j.fertnstert.2018.05.034.Ethics Committee of the American Society for Reproductive Medicine. Fertility preservation and reproduction in patients facing gonadotoxic therapies: an Ethics Committee opinion. Fertil Steril. 2018;110(3):380-386. doi: 10.1016/j.fertnstert.2018.05.034.Oktay K., Harvey B.E., Partridge A.H., Ouinn G.P., Reinecke J., Taylor H.S. et al. Fertility Preservation in Patients With Cancer: ASCO Clinical Practice Guideline Update. J Clin Oncol. 2018;36(19):1994-2001. doi: 10.1200/JCO.2018.78.1914.Oktay K., Harvey B.E., Partridge A.H., Ouinn G.P., Reinecke J., Taylor H.S. et al. Fertility Preservation in Patients With Cancer: ASCO Clinical Practice Guideline Update. J Clin Oncol. 2018;36(19):1994-2001. doi: 10.1200/JCO.2018.78.1914.Floyd J.L., Campbell S., Rauh-Hain J.A., Woodard T. Fertility preservation in women with early-stage gynecologic cancer: optimizing oncologic and reproductive outcomes. Int J Gynecol Cancer. 2021;31(3):345-351. doi: 10.1136/ijgc-2020-001328.Floyd J.L., Campbell S., Rauh-Hain J.A., Woodard T. Fertility preservation in women with early-stage gynecologic cancer: optimizing oncologic and reproductive outcomes. Int J Gynecol Cancer. 2021;31(3):345-351. doi: 10.1136/ijgc-2020-001328.Harada T., Kuji N., Ishihara O., Ichikawa T., Irahara M., Katagiri Y. et al. Guideline for cryopreservation of unfertilized eggs and ovarian tissues in Japan Society of Reproductive Medicine: Ethics Committee in Japan Society of Reproductive Medicine. Reprod Med Biol. 2018;18(1):3-6. doi: 10.1002/rmb2.12236.Harada T., Kuji N., Ishihara O., Ichikawa T., Irahara M., Katagiri Y. et al. Guideline for cryopreservation of unfertilized eggs and ovarian tissues in Japan Society of Reproductive Medicine: Ethics Committee in Japan Society of Reproductive Medicine. Reprod Med Biol. 2018;18(1):3-6. doi: 10.1002/rmb2.12236.Dolmans M.M., Lambertini M., Macklon K.T., Almeida Santos T., Ruiz-Casado A., Borini A. et al. EUropean REcommendations for female FERtility preservation (EU-REFER): A joint collaboration between oncologists and fertility specialists. Crit Rev Oncol Hematol. 2019;138:233-240. doi: 10.1016/j.critrevonc.2019.03.010.Dolmans M.M., Lambertini M., Macklon K.T., Almeida Santos T., Ruiz-Casado A., Borini A. et al. EUropean REcommendations for female FERtility preservation (EU-REFER): A joint collaboration between oncologists and fertility specialists. Crit Rev Oncol Hematol. 2019;138:233-240. doi: 10.1016/j.critrevonc.2019.03.010.Somigliana E., Mangili G., Martinelli F., Noli S., Filippi F., Bergamini A. et al. Fertility preservation in women with cervical cancer. Crit Rev Oncol Hematol. 2020;154:103092. doi: 10.1016/j.critrevonc.2020.103092.Somigliana E., Mangili G., Martinelli F., Noli S., Filippi F., Bergamini A. et al. Fertility preservation in women with cervical cancer. Crit Rev Oncol Hematol. 2020;154:103092. doi: 10.1016/j.critrevonc.2020.103092.Meniru G.I., Craft I.L. Experience with gestational surrogacy as a treatment for sterility resulting from hysterectomy. Hum Reprod. 1997;12(1):51-54. doi: 10.1093/humrep/12.1.51.Meniru G.I., Craft I.L. Experience with gestational surrogacy as a treatment for sterility resulting from hysterectomy. Hum Reprod. 1997;12(1):51-54. doi: 10.1093/humrep/12.1.51.Hoekman EJ., Knoester D., Peters A.A.W., Jansen F.W., de Kroon C.D., Hilders C.GJ.M. Ovarian survival after pelvic radiation: transposition until the age of 35 years. Arch Gynecol Obstet. 2018;298(5):1001-1007. doi: 10.1007/s00404-018-4883-5.Hoekman EJ., Knoester D., Peters A.A.W., Jansen F.W., de Kroon C.D., Hilders C.GJ.M. Ovarian survival after pelvic radiation: transposition until the age of 35 years. Arch Gynecol Obstet. 2018;298(5):1001-1007. doi: 10.1007/s00404-018-4883-5.Gubbala K., Laios A., Gallos I., Pathiraja P., Haldar K., Ind T. Outcomes of ovarian transposition in gynaecological cancers; a systematic review and meta-analysis. J Ovarian Res. 2014;7:69. doi: 10.1186/1757-2215-7-69.Gubbala K., Laios A., Gallos I., Pathiraja P., Haldar K., Ind T. Outcomes of ovarian transposition in gynaecological cancers; a systematic review and meta-analysis. J Ovarian Res. 2014;7:69. doi: 10.1186/1757-2215-7-69.Morice P, Juncker L., Rey A., El-Hassan J., Haie-Meder C., Castaigne D. Ovarian transposition for patients with cervical carcinoma treated by radiosurgical combination. Fertil Steril. 2000;74(4):743-748. doi: 10.1016/s0015-0282(00)01500-4.Morice P, Juncker L., Rey A., El-Hassan J., Haie-Meder C., Castaigne D. Ovarian transposition for patients with cervical carcinoma treated by radiosurgical combination. Fertil Steril. 2000;74(4):743-748. doi: 10.1016/s0015-0282(00)01500-4.Wu X.H., Li Z.T., Huang X., Zhou Y.O., Cheng X., Cai S.M., Zhang Z.Y. Transposed ovarian function conservation in cervical cancer patients with radiotherapy. Zhonghua Fu Chan Ke Za Zhi. 2005;40(4):220-222. Available at: https://pubmed.ncbi.nlm.nih.gov/15924664/.Wu X.H., Li Z.T., Huang X., Zhou Y.O., Cheng X., Cai S.M., Zhang Z.Y. Transposed ovarian function conservation in cervical cancer patients with radiotherapy. Zhonghua Fu Chan Ke Za Zhi. 2005;40(4):220-222. Available at: https://pubmed.ncbi.nlm.nih.gov/15924664/.Agorastos T., Zafrakas M., Mastrominas M. Long-term follow-up after cervical cancer treatment and subsequent successful surrogate pregnancy. Reprod Biomed Online. 2009;19(2):250-251. doi: 10.1016/s1472-6483(10)60080-6.Agorastos T., Zafrakas M., Mastrominas M. Long-term follow-up after cervical cancer treatment and subsequent successful surrogate pregnancy. Reprod Biomed Online. 2009;19(2):250-251. doi: 10.1016/s1472-6483(10)60080-6.Azem F., Yovel I., Wagman I., Kapostiansky R., Lessing J.B., Amit A. Surrogate pregnancy in a patient who underwent radical hysterectomy and bilateral transposition of ovaries. Fertil Steril. 2003;79(5):1229-1230. doi: 10.1016/s0015-0282(03)00148-1.Azem F., Yovel I., Wagman I., Kapostiansky R., Lessing J.B., Amit A. Surrogate pregnancy in a patient who underwent radical hysterectomy and bilateral transposition of ovaries. Fertil Steril. 2003;79(5):1229-1230. doi: 10.1016/s0015-0282(03)00148-1.

The authors declare that there are no conflicts of interest present.