CION Ameerpet
Fertility & Hormone Preservation · Reviewed by CION Oncologists · NABH Accredited
Ovarian Transposition — Moving the Ovaries Out of the Radiation Field
The ovary is one of the most radiation-sensitive organs in the body. For a premenopausal woman, pelvic radiotherapy for cervical cancer will usually stop the ovaries working permanently — an abrupt menopause in her twenties, thirties or forties, on top of a cancer diagnosis. Ovarian transposition is the operation that tries to prevent that, by lifting the ovaries out of the treatment field and pinning them safely above it. It is a small, usually keyhole procedure, it does not delay radiotherapy, and it is recommended in NCCN and ESMO guidance for exactly this situation. It also has real limits, and this page is as clear about those as about the benefits.
- Hormones are the main prize — avoiding an abrupt surgical-style menopause at a young age
- Usually keyhole, often at the same sitting as other planned pelvic surgery — no separate recovery
- It protects against radiation, not chemotherapy — and it does nothing for the uterus
- Protection is real but not absolute — scattered dose still reaches the ovaries, so some women lose function anyway
17+
Cancer Specialists
on Panel
on Panel
96.9%
Breast Cancer
Survival Rate*
Survival Rate*
15,000+
Patients
Treated
Treated
4.8★
Google Rating
(800+ reviews)
(800+ reviews)
What the Operation Actually Does
Radiotherapy for cervical cancer is aimed at the pelvis, and the ovaries sit squarely inside that target area. They are also unusually vulnerable: the doses used to treat cervical cancer are far above what an ovary can survive. Left where they are, they stop working, and the menopause that follows is immediate rather than gradual.
Ovarian transposition, sometimes called oophoropexy, moves them out of the way. Working laparoscopically in most cases, the surgeon separates each ovary from the uterus while keeping its own blood vessels intact, lifts it upwards and outwards, and fixes it high on the side wall of the abdomen, above the pelvic brim and clear of the planned field. Small surgical clips are left to mark exactly where each ovary now sits, so that the radiotherapy planning team can see them on the planning scan and shape the treatment around them. It is a short procedure and it is very often done at the same sitting as surgery that was happening anyway, such as a staging laparoscopy or lymph node assessment.
Nothing about the cancer treatment is compromised to make this possible. The radiation field is designed to treat the disease; transposition simply removes the ovaries from it. Where transposition is being considered, it belongs in the same conversation as egg and embryo freezing before treatment, because the two protect different things and are frequently done together. The wider treatment picture is on the cervical cancer overview.
Did You Know? This is not an unusual request — it is in the guidelines. NCCN's cervical cancer guidance identifies ovarian transposition as an option for premenopausal women who will receive pelvic radiotherapy and wish to preserve ovarian function, and ESMO's fertility preservation guidance says the risk of treatment-induced infertility and early menopause should be discussed with every patient of reproductive age before treatment starts. If radiation has been planned and nobody has mentioned your ovaries, that is a question worth asking out loud. Sources: NCCN Clinical Practice Guidelines in Oncology — Cervical Cancer; ESMO Clinical Practice Guidelines on fertility preservation.
What It Protects — and What It Does Not
Being precise about this saves a lot of later disappointment. Transposition solves one specific problem well and leaves several others untouched.
Protects
Your Own Hormones
The main purpose. Keeping the ovaries producing oestrogen avoids an immediate menopause and everything that comes with it — hot flushes, sleep disruption, vaginal dryness, mood change, and the longer-term effects on bone strength and heart health that matter enormously when menopause arrives decades early.
Protects
Egg Supply, Sometimes
Where ovarian function is preserved, eggs are preserved with it. This keeps assisted conception with your own eggs on the table for the future, and eggs can be collected from transposed ovaries through the abdomen rather than the vagina if that is ever needed.
Does not protect
The Uterus
This is the limit that matters most. Pelvic radiation damages the uterus itself — its blood supply and its ability to stretch — so carrying a pregnancy afterwards is generally not possible even when the ovaries are saved. Transposition preserves hormones and eggs, not the ability to be pregnant.
Does not protect
Against Chemotherapy
Cervical cancer radiotherapy is usually given with chemotherapy alongside it, and chemotherapy travels in the bloodstream. Moving the ovaries physically does nothing about that. It reduces the radiation hit; it does not make the ovaries immune to everything.
Partial
Against Scattered Dose
Even a well-transposed ovary receives some scattered radiation, and the internal component of cervical cancer treatment adds a little more. That is why a proportion of women lose ovarian function despite a technically perfect operation. Protection is meaningful, not guaranteed.
Timing
Before, Never After
Once radiotherapy has been delivered, the damage is done and moving the ovaries achieves nothing. The decision has to be made while the treatment plan is still being drawn up, which is precisely why it needs raising at the first oncology appointment.
Who it suits
Younger Women, Mostly
The younger you are, the more ovarian reserve there is to save and the more years of hormone function are at stake. Suitability also depends on the extent of your disease, on whether the ovaries can safely be spared given your tumour type, and on what other surgery is planned.
Not for everyone
When It Is Not Advised
Some tumour types and some patterns of spread make preserving the ovaries inadvisable, and the oncological decision always comes first. Your tumour board weighs that before transposition is offered — it is never a purely surgical or purely personal choice.
Read that list as two separate questions: what happens to your hormones, and what happens to your ability to carry a pregnancy. They have different answers.
12+ Centres in Hyderabad · Pick yours
CION cancer care is closer than you think.
We're never more than 30 minutes away. Same panel of specialists at every centre. Same tumour board reviews. Same NCCN protocols. Pick the closest one and call directly — or let us pick for you.
CION Ameerpet
CION Kukatpally
CION L.B. Nagar
CION Tolichowki
CION Masab Tank
CION Banjara Hills
CION Kompally
CION Balanagar
CION Siddipet
CION Sangareddy
Not sure which centre fits best? Tell us where you are — we'll suggest the closest one with the right specialists.
Help me pick the right centre
Beyond Hyderabad
35+ centres across Telangana & Andhra Pradesh
Travelling for treatment? We may have a centre right where you are.
Telangana
Andhra Pradesh
Don't see your city? Call 18002028726 — we'll find your nearest CION partner centre.
Meet the Specialists
17+ senior cancer specialists. One panel for your case.
Trained at AIIMS, Tata Memorial, and leading international centres. Combined 150+ years of experience. Every complex case is reviewed by 3+ of them — together.
Medical Oncologist
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Interventional Radiologist
Dr. Mohammed Imran
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
Want a specific doctor for your case? Mention them when booking.
Book Free ConsultationBook an appointment with our specialist
Share your name and number — we'll call you back within 30 minutes to schedule your consultation.
This Decision Has a Deadline
Ovarian transposition can only be done before radiotherapy starts. Bring your reports to a 45-minute consultation and get a straight answer about whether it applies to you. Woman doctor available on request.
How It Fits Into Your Treatment Timetable
The operation itself is the short part. What makes it work is the sequencing — surgeons and radiation oncologists agreeing on where the ovaries need to end up before anybody picks up an instrument.
| Stage | What happens | Why it matters |
|---|---|---|
| At diagnosis | You tell the team your age matters to you and ask about ovarian function | Nothing can be arranged once radiotherapy has started — this is a first-week conversation |
| Tumour board | Surgery, radiation and medical oncology decide whether sparing the ovaries is oncologically safe for your tumour | The cancer decision comes first; transposition is only offered when it does not compromise treatment |
| Planning | The radiation oncologist defines where the treatment field will sit, so the surgeon knows how far the ovaries must travel | Too little movement leaves the ovary in the field; the clips make the new position visible on the planning scan |
| The operation | Usually laparoscopic, often combined with other planned pelvic surgery, done under general anaesthetic | Combining it avoids a second anaesthetic and a second recovery, and avoids delaying treatment |
| Recovery | Keyhole recovery is quick — usually a day or two in hospital, and no delay to the radiotherapy start date | Fertility and hormone preservation should never cost you time on the cancer clock |
| Afterwards | Ovarian function is monitored by symptoms and hormone tests; cysts at the new site are a known finding | If function is lost anyway, hormone replacement is discussed early rather than years later |
For the rest of what pelvic radiotherapy involves, see pelvic radiation side effects, and for the full range of treatment options, cervical cancer treatment in Hyderabad.
The Risks, and the Things Worth Knowing Beforehand
Transposition is a low-risk operation as pelvic surgery goes, particularly when it is added to a procedure that was happening anyway. It is not without risk, and there are a few consequences that surprise women afterwards if nobody mentioned them.
Cysts at the new site
Ovarian cysts developing at the transposed position are the commonest thing that happens afterwards. Most cause no trouble and are simply watched on a scan. A minority cause pain or need draining. They can also be alarming on a routine scan if the person reporting it has not been told your ovaries were moved — which is one good reason to carry that detail in your own records.
Loss of function despite everything
Some women go through the operation and still enter the menopause. Scattered radiation dose, chemotherapy given alongside, and age all contribute. This is not a failure of the surgery or a mistake by anyone; it is the honest limit of what moving an organ a few centimetres can achieve. If it happens, the conversation turns to hormone replacement and bone protection — covered on early menopause after cervical cancer treatment.
Surgical risks and rare complications
The usual risks of a laparoscopic procedure apply: anaesthetic risk, bleeding, infection, injury to nearby structures. Specific to this operation, the blood supply to a moved ovary can occasionally be compromised, and an ovary can shift back downwards over time. Chronic discomfort at the new site is uncommon but reported. Your surgeon will quantify these for your own case.
Egg collection later is done differently
Standard egg retrieval goes through the vagina, and a transposed ovary is no longer reachable that way. If assisted conception is used in future, eggs are collected through the abdominal wall instead. It is entirely doable, but the fertility unit needs to know in advance rather than discovering it on the day.
The sentence to hold on to: transposition is about hormones. If your goal is a future pregnancy that you carry yourself, transposition alone will not deliver it after pelvic radiation, and the conversation you need is a wider one — freezing eggs or embryos beforehand, and what the law permits afterwards. Ask for both conversations in the same appointment, before your radiation start date is fixed.
Did You Know? The reason this operation exists at all is that cervical cancer strikes young. WHO identifies it as one of the most common cancers among women of reproductive age worldwide, and in India it remains among the leading causes of cancer death in women — which is why WHO's elimination strategy pairs HPV vaccination and screening with access to proper treatment. A woman treated in her thirties has forty more years to live with whatever the treatment leaves behind, and that is precisely why hormone preservation is worth an extra half hour in theatre. Sources: WHO Global Strategy to Accelerate the Elimination of Cervical Cancer; ICMR-NCDIR National Cancer Registry Programme.
Why This Conversation Happens Properly at CION
Ovarian transposition only gets offered where surgeons and radiation oncologists plan in the same room.
Raised before the plan is fixed
Radiation and surgery plan together
Tumour board for every diagnosis
Fertility and hormones handled as two questions
Woman doctor available on request
45-minute detailed consultation
7 NABH-accredited Hyderabad locations
EMI facility & insurance accepted
4.8 / 5 Google rating
Take The Next Step
Ask the Question While It Can Still Be Answered
One consultation tells you whether ovarian transposition is possible in your case, what it would and would not protect, and how it fits alongside everything else in your plan.
Real Stories. Real Voices.
15,000+ patients chose CION. Hear from them directly.
These aren't paid endorsements or written reviews. These are video testimonials from real patients and families — recorded on their own phones, in their own words. Pick any one. Watch it. Then decide.
4.8★800+ Google reviews
50+video testimonials
15,000+patients treated
Read all 800+ reviews on Google
Start Your Story. Book Free Consultation.
Common questions
Ovarian Transposition — Frequently Asked Questions
What is ovarian transposition and when does it need to be done?
It is an operation that moves the ovaries out of the area that pelvic radiotherapy will treat. Each ovary is separated from the uterus with its own blood supply kept intact, lifted upwards and outwards, and fixed above the pelvic brim, clear of the treatment field. Small surgical clips mark the new position so the radiotherapy planning team can see and avoid them. It is usually done laparoscopically, and very often at the same sitting as other planned pelvic surgery. Crucially, it has to happen before radiotherapy begins — once radiation has been delivered, moving the ovaries achieves nothing.
Does moving the ovaries guarantee I will not go into early menopause?
No, and anyone who tells you otherwise is overselling it. Transposition meaningfully reduces the radiation dose the ovaries receive, and many women keep their ovarian function because of it. But scattered radiation still reaches them, the internal component of cervical cancer treatment adds a little more, and chemotherapy given alongside radiotherapy affects the ovaries through the bloodstream regardless of where they sit. Younger women tend to do better, because they start with more ovarian reserve. If function is lost anyway, that is not a surgical failure — and the conversation then turns to hormone replacement and bone protection, which should start early rather than years later.
Can I still carry a pregnancy after ovarian transposition?
Generally not, if you have had pelvic radiotherapy, and this is the single most important thing to be clear about. Transposition protects the ovaries — your hormones and potentially your eggs — but it does nothing for the uterus, and pelvic radiation damages the uterus itself, reducing its blood supply and its ability to stretch. So a woman may keep normal ovarian function and still be unable to carry a pregnancy. Where the uterus cannot carry, stored or retrieved eggs can only lead to a baby through a legally permitted surrogacy arrangement in India. If carrying a pregnancy yourself is your goal, that is a different conversation and it needs to happen before treatment is planned.
What are the risks and side effects of the operation itself?
As pelvic surgery goes it is low risk, especially when added to a procedure that was already planned. The usual laparoscopic risks apply — anaesthetic risk, bleeding, infection, and injury to nearby structures. Specific to this operation, ovarian cysts at the new site are the commonest finding afterwards, and most need nothing more than a scan to keep an eye on them. Less commonly, the blood supply to a moved ovary is compromised, the ovary migrates back downwards over time, or there is persistent discomfort at the new site. Recovery is usually a day or two in hospital, and it should not delay your radiotherapy start date.
Will the ovaries be put back where they were afterwards?
Usually not. Once radiotherapy is complete the ovaries are generally left in their new position, because a second operation carries its own risks for no clear benefit — an ovary works just as well higher up as it does in the pelvis. The practical consequence is worth knowing in advance: if you later need eggs collected for assisted conception, the standard route through the vagina is no longer possible, so collection is done through the abdominal wall instead. Tell any fertility unit, and any radiologist scanning your pelvis, that your ovaries have been transposed — it changes what they expect to see.
Medical disclaimer: This page is general health information, reviewed by a CION oncologist. Whether ovarian transposition is appropriate depends on your tumour type, stage and planned radiation field, and the oncological decision always takes precedence over fertility or hormone considerations. It is not a diagnosis and cannot replace a consultation with your own oncology team.