Treatment Overview
Ovarian Transposition (also known as Oophoropexy) is a surgical fertility preservation technique designed to protect the ovaries from radiation damage during cancer treatment. It involves repositioning one or both ovaries outside of the pelvic radiation field—typically higher in the abdomen or behind protective tissue—to minimize exposure while maintaining their blood supply and hormonal function.
In Korea, ovarian transposition is performed using advanced laparoscopic or robotic-assisted techniques, ensuring high surgical precision and minimal recovery time. This method is often used for patients undergoing pelvic or abdominal radiotherapy, such as for cervical, rectal, or bladder cancers, where direct ovarian exposure to radiation could lead to infertility or early menopause.
Korean reproductive and surgical teams work in close coordination with oncology departments to plan the optimal transposition location, ensuring both cancer treatment safety and fertility preservation.
Purpose & Benefits
The goal of ovarian transposition is to preserve ovarian function and fertility by physically moving the ovaries away from the radiation target zone.
Key benefits include:
- Protection from radiation exposure: Shields the ovaries from high-dose radiation during pelvic cancer treatment.
- Preservation of hormone function: Maintains natural estrogen and progesterone production, preventing premature menopause.
- Potential for natural conception: Ovarian function may continue normally post-treatment, allowing spontaneous ovulation.
- Compatibility with assisted reproduction: Eggs can later be retrieved for IVF if natural conception is not feasible.
- Quick procedure: Can be performed laparoscopically within a few hours, often during another surgical stage.
- Long-term fertility safeguard: Offers protection even when other methods (like egg freezing) are not possible due to time constraints.
In Korea, ovarian transposition is an integral part of multidisciplinary oncofertility programs, ensuring fertility protection is seamlessly incorporated into cancer care.
Ideal Candidates
Ovarian transposition is suitable for:
- Women undergoing pelvic or abdominal radiation therapy for cancers such as cervical, rectal, or anal cancer.
- Patients of reproductive age (typically under 40) wishing to preserve fertility and hormonal function.
- Individuals with limited time before starting cancer treatment who cannot undergo ovarian stimulation.
- Patients with hormone-sensitive cancers where ovarian suppression is used alongside surgery.
- Women who have already completed family planning for other preservation methods (optional for ovarian function maintenance).
It is especially effective for patients who require immediate radiation and cannot delay therapy for egg or embryo cryopreservation.
Possible Risks & Complications
While generally safe and effective, ovarian transposition may carry certain surgical and treatment-related risks:
- Surgical complications: Minimal bleeding, infection, or pain at incision sites.
- Ovarian failure: If blood supply is compromised or radiation scatter still affects the ovaries.
- Ovarian cyst formation: Occasionally occurs after repositioning but is usually benign.
- Torsion risk: The ovary may twist after relocation, although rare with proper fixation.
- Radiation scatter exposure: Even relocated ovaries can receive low-dose radiation, potentially affecting function.
- Future egg retrieval challenges: Accessing transposed ovaries may be more complex for IVF later.
Korean hospitals mitigate these risks with image-guided planning, surgical mapping, and radiation-field simulations, ensuring precision and safety.
Surgical Techniques Used
Korean fertility and surgical teams employ minimally invasive methods for ovarian transposition, combining reproductive surgery expertise with oncology collaboration.
1. Laparoscopic Ovarian Transposition
- Performed under general anesthesia using small incisions in the abdomen.
- One or both ovaries are gently mobilized along with their vascular pedicles.
- The ovaries are moved higher in the abdomen—typically above the pelvic brim or outside the radiation field.
- Fixation is achieved using non-absorbable sutures to the peritoneal wall or near the diaphragm.
- The fallopian tubes are also repositioned if necessary to maintain potential for natural fertilization.
2. Robotic-Assisted Oophoropexy
- Some Korean centers use robotic surgical systems for enhanced precision and visualization.
- Allows for delicate handling of ovarian vessels and accurate placement with minimal trauma.
- Reduces recovery time and improves postoperative outcomes.
3. Image-Guided Radiation Planning
- Pre- and post-operative imaging (CT/MRI) is used to confirm ovarian location and protection level.
- Collaboration between radiation oncologists and surgeons ensures the relocated ovaries remain outside the radiation zone.
4. Adjunctive Ovarian Shielding
- In cases where relocation alone isn’t sufficient, lead or polymer shields are used to further reduce radiation scatter.
Korean surgical centers are recognized for their refined laparoscopic expertise, precise vascular management, and integration with radiation planning systems.
Recovery & Aftercare
Recovery from ovarian transposition in Korea is typically rapid and uncomplicated:
- Hospital stay: Usually 1 day or performed as same-day surgery.
- Physical recovery: Mild abdominal discomfort or bloating for a few days.
- Resumption of cancer therapy: Radiotherapy can begin within 2–5 days after surgery.
- Hormonal monitoring: Regular testing of estrogen, FSH, and LH levels to confirm ovarian activity.
- Ultrasound follow-up: To confirm ovarian location and assess blood flow post-surgery.
- Fertility follow-up: Patients may undergo ovarian reserve testing (AMH levels) periodically after radiation.
Korean medical teams emphasize close collaboration between oncologists and reproductive endocrinologists during aftercare to ensure both fertility and cancer outcomes are optimized.
Results & Longevity
Clinical data from Korean fertility and oncology programs demonstrate high success rates in ovarian function preservation after transposition.
Typical results include:
- Ovarian function preservation: Achieved in approximately 70–90% of patients, depending on radiation type and dose.
- Hormonal maintenance: Majority retain normal estrogen levels post-treatment.
- Menstrual cycle recovery: Regular menstruation resumes in many patients following therapy completion.
- Long-term fertility: Natural conception possible in select cases, or assisted reproduction via IVF with relocated ovaries.
- Hormone longevity: Preserved ovarian function often maintained for years post-radiation.
Korea’s integrated oncology-fertility care ensures consistent monitoring, improving both ovarian survival and reproductive outcomes.
Treatment Process in Korea
Step 1 – Preoperative Consultation
- Joint evaluation by oncology and fertility teams.
- Review of radiation field, cancer type, and fertility goals.
- Hormone testing and ultrasound mapping of ovarian position.
Step 2 – Surgical Planning
- Personalized mapping using imaging to determine relocation site.
- Decision on unilateral or bilateral transposition based on cancer location and treatment area.
Step 3 – Laparoscopic Transposition
- Ovaries mobilized and repositioned safely outside radiation field.
- Fixation ensures stability and maintains vascular integrity.
Step 4 – Postoperative Verification
- Imaging confirms correct ovarian positioning.
- Surgery documentation shared with the radiation oncology team for treatment planning.
Step 5 – Cancer Therapy & Follow-Up
- Radiotherapy or chemotherapy proceeds as scheduled.
- Regular hormone and ultrasound follow-up to monitor ovarian health.
Why Korea Is a Leading Destination
- Pioneering reproductive surgery: Korean hospitals are internationally recognized for minimally invasive fertility preservation surgery.
- Integrated oncofertility programs: Seamless collaboration between oncology, fertility, and imaging departments.
- Cutting-edge technology: Use of 3D laparoscopic and robotic systems for precise ovarian relocation.
- Comprehensive patient support: Includes hormonal monitoring, psychological counseling, and fertility restoration options.
- Cost-effectiveness: Advanced procedures at significantly lower cost compared to Western countries.
- High success and satisfaction rates: Backed by extensive clinical experience in fertility preservation for cancer patients.
These factors make Korea a global hub for ovarian transposition and oncofertility care.
Cost Range
The cost of ovarian transposition in Korea varies based on hospital, technique, and patient condition. Typical cost estimates include:
- Laparoscopic transposition surgery: USD 3,000 – 5,000
- Robotic-assisted procedure: USD 5,000 – 7,000
- Preoperative imaging and mapping: USD 300 – 700
- Hormonal and fertility monitoring: USD 200 – 500
- Comprehensive fertility preservation package: USD 5,000 – 8,000
This is substantially lower than similar procedures in North America or Europe while maintaining world-class medical quality and post-surgical care.
Popular Clinics in Korea
- CHA Fertility Center (Seoul, Bundang): Leading institution offering laparoscopic and robotic ovarian transposition integrated with oncofertility services.
- Maria Fertility Hospital: Known for advanced surgical fertility preservation and radiation planning coordination.
- MizMedi Women’s Hospital: Specializes in minimally invasive oncofertility surgery and reproductive restoration.
- Hamchoon Women’s Clinic: Offers tailored ovarian protection and fertility preservation protocols for cancer patients.
- Seoul Women’s Hospital: Provides full-spectrum fertility preservation and international patient support.
