Sonographic Imaging of Surgically Transpositioned Ovaries in the Treatment of Rectal Carcinoma

2021 ◽  
pp. 875647932110465
Author(s):  
Sovereign K. Ortiz
Keyword(s):  
Rectal Carcinoma ◽  
Ovarian Function ◽  
Rectal Adenocarcinoma ◽  
Reproductive Age ◽  
Ovarian Transposition ◽  
Oncological Outcomes ◽  
Sonographic Evaluation ◽  
After Cancer ◽  
Insight Into ◽  
Sonographic Imaging

Pelvic radiation therapy in patients with advanced rectal carcinoma improves oncological outcomes, but often raises infertility concerns in reproductive-age patients. Laparoscopic ovarian transposition is a surgical method which may offer preservation of ovarian function during and after cancer treatment. Sonographic evaluation of the ovaries post transposition gives insight into their condition and the efficacy of ovarian transposition in the continuation of ovarian function after radiation. This case describes how sonography was used to identify and evaluate surgically transpositioned ovaries in a patient with rectal adenocarcinoma.

Laparoscopic ovarian transposition in patients with pelvic cancer

2014 ◽  
Vol 20 (4) ◽  
pp. 207-212
Author(s):  
Kastytis Žilinskas ◽  
Živilė Sabonytė-Balšaitienė ◽  
Narimantas Evaldas Samalavičius
Keyword(s):  
Rectal Cancer ◽  
Ovarian Function ◽  
Vena Cava ◽  
Premenopausal Women ◽  
Tumor Stage ◽  
Reproductive Age ◽  
Stage Iii ◽  
Ovarian Transposition ◽  
Hospitalization Period ◽  
Pelvic Cancer

Background. The aim of this study was to evaluate the feasibility of laparoscopic ovarian transposition prior to radiation therapy on the preservation of hormonal function in the treatment of pelvic cancer. Materials and methods. A chart review of premenopausal women diag­nosed with pelvic cancer, who underwent laparoscopic ovarian transposition to paracolic gutters, then received preoperative radiotherapy at the Center of Oncosurgery, Oncology Institute of Vilnius, from January 2010 to July 2013. Results. A total of 14 patients underwent laparoscopic ovarian transposition. Patients were divided into two groups by localisation of can­cer: 2 (14.29%) patients diagnosed with rectal cancer and 12 (85.71%) with cervical cancer. Patients’ age was from 24 to 42  years with a mean age of 33.71 (SD  ±  5.22) years. The average age of the patients in the first group was 26 (SD ±  2.83) years. In the second group women, aged 29 and 42 years with a mean age of 35 (SD ± 4.35) years, were analyzed. Rectal cancer of stage III was diagnosed in both women of the first group. Tumor stage distribution in the second group, respectively: stage I  –  2  cases (16.67%), stage  II  –  3  cases (25%), stage  III  –  7 cases (58.33%). Seven (58.33%) patients of the second group underwent complete endoscopic staging. In these groups of 14 patients there were 2 (14.3%) complications (injury of the inferior vena cava and postoperative abnormal vaginal bleeding). No postoperative exitus occurred. The mean duration of the operation was 2 hours 26 minutes ± 55 minutes (60–245 minutes), respectively, 2  hours 40  minutes  ±  49  minutes (95–245  minutes) when laparoscopic staging and ovarian transposition was performed and 2  hours 12  minutes  ±  1  hour 1  minute (60–245  minutes) when only ovarian transposition was performed. The hospitalization period ranged from 5 to 52 days (average 12 days). Conclusions. Laparoscopic ovarian transposition is a relatively safe and effective procedure for preserving ovarian function. This procedure should be considered in all reproductive age female patients who need to undergo pelvic irradiation as part of pelvic cancer treatment.

Laparoscopic Ovarian Transposition Before Pelvic Cancer Treatment: Ovarian Function and Fertility Preservation

2017 ◽  
Vol 24 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Nash S. Moawad ◽  
Estefania Santamaria ◽  
Alice Rhoton-Vlasak ◽  
Judith L. Lightsey
Keyword(s):  
Cancer Treatment ◽  
Fertility Preservation ◽  
Ovarian Function ◽  
Ovarian Transposition ◽  
Pelvic Cancer

Obesity and oocyte quality: Significant implications for ART and Emerging mechanistic insights

2021 ◽  
Author(s):  
Macarena B Gonzalez ◽  
Rebecca L Robker ◽  
Ryan D Rose
Keyword(s):  
Pregnancy Complications ◽  
Maternal Obesity ◽  
Ovarian Function ◽  
Polycystic Ovary ◽  
Live Birth Rate ◽  
Oocyte Quality ◽  
Reproductive Age ◽  
Developmental Competence ◽  
Obese Women ◽  
Increased Risk

Abstract The prevalence of obesity in adults worldwide, and specifically in women of reproductive age, is concerning given the risks to fertility posed by the increased risk of type 2 diabetes, metabolic syndrome and other non-communicable diseases. Obesity has a multi-systemic impact in female physiology that is characterized by the presence of oxidative stress, lipotoxicity, and the activation of pro-inflammatory pathways, inducing tissue-specific insulin resistance and ultimately conducive to abnormal ovarian function. A higher body mass is linked to Polycystic Ovary Syndrome, dysregulated menstrual cycles, anovulation, and longer time to pregnancy, even in ovulatory women. In the context of ART, compared to women of normal BMI, obese women have worse outcomes in every step of their journey, resulting in reduced success measured as live birth rate. Even after pregnancy is achieved, obese women have a higher chance of miscarriage, gestational diabetes, pregnancy complications, birth defects, and most worryingly, a higher risk of stillbirth and neonatal death. The potential for compounding effects of ART on pregnancy complications and infant morbidities in obese women has not been studied. There is still much debate in the field on whether these poorer outcomes are mainly driven by defects in oocyte quality, abnormal embryo development or an unaccommodating uterine environment, however the clinical evidence to date suggests a combination of all three are responsible. Animal models of maternal obesity shed light on the mechanisms underlaying the effects of obesity on the peri-conception environment, with recent findings pointing to lipotoxicity in the ovarian environment as a key driver of defects in oocytes that have not only reduced developmental competence but long-lasting effects in offspring health.

scholarly journals Association between the location of transposed ovary and ovarian dose in patients with cervical cancer treated with postoperative pelvic radiotherapy

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Xiao-juan Lv ◽  
Xiao-long Cheng ◽  
Ye-qiang Tu ◽  
Ding-ding Yan ◽  
Qiu Tang
Keyword(s):  
Cervical Cancer ◽  
Radical Hysterectomy ◽  
Adjuvant Radiotherapy ◽  
Iliac Crest ◽  
Ovarian Function ◽  
Pelvic Radiotherapy ◽  
Cutoff Value ◽  
Ovarian Transposition ◽  
Transverse Distance ◽  
Upper Boundary

Abstract Background and purpose How to protect the ovarian function during radiotherapy is uncertain. The purpose of this study was to explore the association between the location of the transposed ovary and the ovarian dose in patients with cervical cancer received radical hysterectomy, ovarian transposition, and postoperative pelvic radiotherapy. Methods A retrospective analysis was conducted of 150 young patients with cervical cancer who received radical hysterectomy, intraoperative ovarian transposition, and postoperative adjuvant radiotherapy in Zhejiang Cancer Hospital. Association between location of the transposed ovaries and ovarian dose was evaluated. The transposed position of ovaries with a satisfactory dose was explored using a receiver operator characteristic curve (ROC) analysis. Patients’ ovarian function was followed up 3 months and 1 year after radiotherapy. Results A total of 32/214 (15%) transposed ovaries were higher than the upper boundary of the planning target volume (PTV). The optimum cutoff value of > 1.12 cm above the iliac crest plane was significantly associated with ovaries above the upper PTV boundary. When the ovaries were below the upper boundary of PTV, the optimum cutoff value of transverse distance > 3.265 cm between the ovary and PTV was significantly associated with ovarian max dose (Dmax) ≤ 4Gy, and the optimum cutoff value of transverse distance > 2.391 cm was significantly associated with ovarian Dmax≤5Gy. A total of 77 patients had received complete follow-up, and 56 patients (72.7%) showed preserved ovarian function 1 year after radiotherapy, which was significantly increased compared with 3 months (44.2%) after radiotherapy. Conclusions The location of transposed ovaries in patients with cervical cancer is significantly correlated with ovarian dose in adjuvant radiotherapy. We recommend transposition of ovaries > 1.12 cm higher than the iliac crest plane to obtain ovarian location above PTV. When the transposed ovary is below the upper boundary of PTV, ovarian Dmax ≤4Gy may be obtained when the transverse distance between the ovary and PTV was > 3.265 cm, and the ovarian Dmax≤5Gy may be obtained when the transverse distance was > 2.391 cm.

Serum anti-Müllerian hormone levels in reproductive-age women with relapsing–remitting multiple sclerosis

2014 ◽  
Vol 21 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Jan Thöne ◽  
Susanne Kollar ◽  
Darryl Nousome ◽  
Gisa Ellrichmann ◽  
Ingo Kleiter ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Ovarian Reserve ◽  
Ovarian Function ◽  
Reproductive Age ◽  
Unexpected Finding ◽  
Healthy Controls ◽  
Relapsing Remitting ◽  
Disease Modifying Treatment ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Control Study

Background: Fertility might be reduced in women with multiple sclerosis (MS), although only few studies exist and the underlying reasons are not well understood. Similar to other autoimmune diseases, a decreased ovarian reserve may contribute to impaired fertility in women with MS. Anti-Müllerian hormone (AMH) is an established marker of the ovarian reserve and an objective indicator of ovarian function, which is independent of the hypothalamus-pituitary-gonadal axis function. Objective: The purpose of this study was to determine AMH levels in females with relapsing–remitting MS (RRMS) in combination with other reproduction and lifestyle factors. Methods: A total of 76 reproductive-age females with RRMS and 58 healthy controls were included in this case control study. An enzymatically amplified two-site immunoassay was used to measure serum AMH level. Results: Mean AMH level was significantly decreased in females with RRMS ( p<0.04), and a higher proportion of females with RRMS showed very low AMH values (<0.4 ng/ml) compared to healthy controls ( p<0.05). The majority of these women were currently without any disease modifying treatment. Conclusions: Our data contribute to our understanding of impaired fertility in women with MS. The unexpected finding that the majority of MS subjects with very low AMH levels were currently without medication requires further evaluation.

Uterine artery embolization in uterine fibroids patients of reproductive age and its role in shaping of autoimmune oophoritis

2016 ◽  
Vol 3 (2) ◽  
pp. 81-87
Author(s):  
Elena A. Sosnova
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Ovarian Function ◽  
Clinical Laboratory ◽  
Uterine Fibroids ◽  
Treatment Method ◽  
Reproductive Age ◽  
Long Term Results ◽  
Artery Embolization ◽  
Premature Failure

In women of the reproductive age who have preserved the uterus after uterine artery embolization (UAE) and are interested in restoring fertility, the clinical evaluation of long-term results of this treatment method was executed with the use both of a questionnaire survey (n = 98), and determination of the status of ovarian reserve, ovaries, thyroid gland(n = 52). Performed retro- and prospective clinical-laboratory and instrumental methods of the investigation allowed to reveal a higher risk of the development of remote complications of UAE, in particular in the premature failure of ovarian function.

Preoperative concomitant chemoradiotherapy with oxaliplatin and 5-fluorouracil in locally advanced rectal carcinoma

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15108-e15108
Author(s):  
L. Djellali ◽  
B. Larbaoui ◽  
A. Boukerche ◽  
S. Ghazi ◽  
I. Chaiba ◽  
...  
Keyword(s):  
Folinic Acid ◽  
Rectal Carcinoma ◽  
Anal Verge ◽  
Clinical Stage ◽  
Locally Advanced ◽  
Rectal Adenocarcinoma ◽  
Sphincter Preservation ◽  
Postoperative Treatment ◽  
Treatment Schedule ◽  
Concomitant Chemoradiotherapy

e15108 Background: Preoperative concomitant chemoradiotherapy has shown to improve local control and sphincter preservation with decreased acute toxicity compared with postoperative treatment in locally advanced rectal carcinoma. The primary endpoint of this phase II trial was pathologic tumor response. Secondary endpoint was sphincter preservation and toxicity Methods: Inclusion criteria: rectal adenocarcinoma <12 cms from anal verge, clinical stage T3–4, adequate renal, hematological and liver function. Planned sample for this trial was 40 patients. Treatment schedule: Pelvic radiotherapy (25 Gy/ 5 fractions: 5 Gy on day 1 to day 5) and chemotherapy: Oxaliplatin 85 mg/m2 on 2 hours, day 1 and 15, folinic acid 20 mg/m2 and 5 fluoro-uracil bolus 500 mg/m2 on day 1, 8 and 15 (cycle repeated every 4 weeks). Surgery with TME was performed after the end of the second cycle of chemotherapy. Adjuvant chemotherapy with 5FULV2 was administered after surgery Results: 15 patients have been recruited between January and October 2006: 10 males/5 females. Median age: 45 years (range 26–62). Clinical stage (determined by CT or RMI): T3: 66.6% and T4: 33.3%. Tumor location (from anal verge): < 6 cm in 10pts, >6 cm in 5pts. Surgery (performed in 14 patients) consisted of low anterior resection in 5pts and abdominal-perineal resection in 10p. Tumor down-staging was observed in 10pts (66.6%), including 5pts with complete pathological response (33.3%). Main adverse effects (NCI-CTC): diarrhea G3–4: 14.2%, sensitive peripheral neurotoxicity G1: 26.6%, nausea/vomiting G3–4: 11%, Anemia G3–4: 7.1%, neutropenia G3–4: 14.2% Conclusions: Preliminary results show that preoperative concomitant chemoradiotherapy with oxaliplatin and 5FU-folinic acid is an effective regimen with an acceptable safety profile for locally advanced rectal cancer, leading to a high probability of tumor downstaging. This interim analysis has to be confirmed by the final analysis. No significant financial relationships to disclose.

scholarly journals Reduced recruitment and survival of primordial and growing follicles in GH receptor-deficient mice

Reproduction ◽  
2006 ◽  
Vol 131 (3) ◽  
pp. 525-532 ◽  
Author(s):  
Karin A Slot ◽  
Jan Kastelijn ◽  
Anne Bachelot ◽  
Paul A Kelly ◽  
Nadine Binart ◽  
...  
Keyword(s):  
Ovarian Function ◽  
Laron Syndrome ◽  
Knock Out ◽  
Primordial Follicles ◽  
Antral Follicles ◽  
Gh Receptor ◽  
Igf I ◽  
Follicular Reserve ◽  
Deficient Mice ◽  
Insight Into

GH influences female fertility. The goal of the present study was to obtain more insight into the effect of loss of GH signalling, as observed in humans suffering from Laron syndrome, on ovarian function. Therefore, serial paraffin sections of ovaries of untreated and IGF-I-treated female GH receptor knock-out (GHR/GHBP-KO) mice were examined to determine the follicular reserve and the percentage of follicular atresia in each ovary. Our observations demonstrate that the amount of primordial follicles was significantly elevated in GHR/GHBP-KO mice, while the numbers of primary, preantral and antral follicles were lower compared with wild-type values. The reduced number of healthy growing follicles in GHR/GHBP-KO mice was accompanied by a significant increase in the percentage of atretic follicles. IGF-I treatment of GHR/GHBP-KO mice for 14 days resulted in a reduced number of primordial follicles, an increased number of healthy antral follicles, and a decreased percentage of atretic follicles. The results of the present study suggest that GH may play a role, either directly or indirectly, via for instance IGF-I, in the recruitment of primordial follicles into the growing pool. Furthermore, GH seems to protect antral follicles, directly or indirectly from undergoing atresia.

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