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Moving the ovaries out of the way before pelvic radiation | CION Cancer Clinics
Ovarian transposition is a keyhole operation that moves the ovaries up and out of the area pelvic radiation will treat. It can lower the dose they receive and may help keep your eggs and your natural hormones. It does not protect the womb, and it offers no protection against chemotherapy. This page explains who is usually offered it, what happens, and what it cannot promise. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What is ovarian transposition, and why is it done before radiation?
- When do doctors usually raise ovarian transposition?
- What happens, from the decision to the first radiation session?
- What do the words on the consent form mean?
- What do families often believe about this operation?
- Who is it not suited to, and what can this page not tell you?
- Common questions about ovarian transposition
The short answer
What is ovarian transposition, and why is it done before radiation?
Ovarian transposition is a keyhole operation that lifts one or both ovaries up and out of the area that pelvic radiation will treat. Moving them a short distance can lower the dose they receive, which may protect the eggs and the hormones they make.
Why the ovaries need protecting
The ovaries are very sensitive to radiation. Even a modest dose can destroy the eggs stored inside them and stop them making hormones. When that happens, periods stop and menopause arrives early, sometimes within months of treatment.
Two separate things it may protect
The first is fertility, meaning the chance of eggs being available later. The second is hormone function. Many women value the second just as much, because an early menopause brings hot flushes, bone thinning and a higher long-term risk to the heart. Some women choose the operation mainly for this reason, even when they do not plan a pregnancy.
What it does not protect
It does nothing for the womb, which stays in the radiation field. It also offers no protection against chemotherapy, which reaches the ovaries wherever they sit in the body.
Whether this operation fits your plan is a decision for your treating team. This page explains what they weigh.Who is asked about it
When do doctors usually raise ovarian transposition?
It is discussed when pelvic radiation is planned and the ovaries are healthy.
Early cervical cancer
Some women with cervical cancer need radiation after surgery, or instead of it. The ovaries can sometimes be moved during the same keyhole operation that checks the lymph nodes, the small glands where cancer often spreads first.
Certain types of cervical cancer spread to the ovary more often, and moving them may not be advised.Rectal and anal cancer
Radiation for these cancers covers much of the pelvis. A younger woman may be offered transposition before radiation begins, often alongside other fertility options.
Lymphoma and pelvic tumours
Some lymphomas, and tumours of the pelvic bones or soft tissue, need radiation close to the ovaries. The team compares how far the ovaries can be moved with the size of the area being treated.
What the team checks first
Before recommending it, the team looks at several things together.
Usually weighed
- Your age and how many eggs remain
- Whether chemotherapy is also planned
- The exact area radiation will cover
- Any sign of cancer in or near the ovary
Not sure whether this applies to you?
Ask an oncologistThe pathway
What happens, from the decision to the first radiation session?
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A joint discussion
Your surgeon and radiation oncologist agree on where the radiation field will end, and therefore where the ovaries need to go. A fertility specialist may join the conversation, especially if egg freezing is also being considered.
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Tests before the operation
Usually blood tests, a scan and a check that you are fit for general anaesthesia. A blood test for ovarian reserve, which estimates how many eggs remain, may be advised.
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The keyhole operation
Through a few small cuts, the surgeon frees each ovary on its blood supply and stitches it higher up, usually towards the side of the abdomen. Small metal clips are placed so the radiation team can see the ovaries on their planning scan.
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Going home
Many women go home the same day or the next. Shoulder-tip pain from the gas used in keyhole surgery is common and settles on its own.
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Radiation planning
Radiation usually starts soon after, because ovaries can slowly drift back towards the pelvis. The planning scan confirms where the clips sit before treatment begins.
On your paperwork
What do the words on the consent form mean?
- Oophoropexy
- Another name for ovarian transposition. It means fixing the ovary in a new position with stitches.
- Radiation field
- The area of the body the radiation beams are aimed at. The aim of transposition is to place the ovaries outside it.
- Ovarian reserve
- An estimate of how many eggs remain. It helps the team judge how much there is to protect.
- Scatter dose
- Radiation that spreads a little beyond the edge of the field. It is why moved ovaries still receive some dose.
- Premature ovarian insufficiency
- When the ovaries stop working before the natural age of menopause. This is what the operation tries to prevent.
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Commonly believed
What do families often believe about this operation?
"Once the ovaries are moved, fertility is safe."
Moving the ovaries lowers the dose they receive. It does not remove it. Some ovaries still stop working after treatment, and the chance of that depends on the dose, your age and whether chemotherapy is also given. Think of it as improving the odds, not settling them.
"If my ovaries work, I can carry a pregnancy normally."
The womb usually stays in the radiation field. Radiation can leave it smaller and stiffer, which makes carrying a pregnancy harder or unsafe. Some women later need eggs collected and a pregnancy carried by someone else, which in India is closely regulated by law.
"This operation will delay my cancer treatment."
It is a short keyhole procedure and is usually planned to fit into the gap before radiation. In cervical cancer it is often done during an operation that was already planned. Your team will tell you if it would push treatment back.
"It is only worth it if we want another child."
Keeping hormone function can matter even without a pregnancy plan. An early menopause affects bones, the heart, sleep and sexual life. It is reasonable to ask about the operation for that reason alone.
Being straight with you
Who is it not suited to, and what can this page not tell you?
Ovarian transposition is not offered to everyone having pelvic radiation. It is usually not suggested for women close to menopause, where few eggs remain. It is also not suggested when heavy chemotherapy is planned that would affect the ovaries anyway.
When the cancer itself rules it out
If there is any sign of cancer in or near an ovary, moving it could carry cancer cells to a new place. Some cancer types spread to the ovary more often, and in those cases many surgeons advise removing the ovaries instead. Your pathology report and scans guide this decision.
Risks worth asking about
Like any operation, it carries risks of bleeding, infection and injury to nearby organs. Afterwards, a moved ovary can form cysts or cause aching. It can also be harder to reach later if eggs need to be collected. Ask your surgeon how often they see these problems in their own practice.
What this page cannot tell you
It cannot tell you how much dose your ovaries will receive, or whether they will keep working. Only your radiation plan can estimate the first, and nobody can promise the second.
Did you know
The small clips placed during transposition are not only a marker for the radiation team. They also let doctors find the ovaries on future scans, which matters if you later need an ultrasound or egg collection. Keep your operation note with your other reports.
Questions we are asked
Common questions about ovarian transposition
Will I still have periods after the operation?
The operation itself does not stop periods. What happens after radiation depends on how much dose the ovaries receive and whether you also have chemotherapy. If the womb lining is damaged by radiation, periods can become light or stop even when the ovaries still make hormones. Your team can explain what to expect in your case.
Is it done as open surgery or keyhole?
It is usually done by keyhole surgery under general anaesthesia. If you are already having an open operation for your cancer, the surgeon may move the ovaries during that operation instead. Ask your centre which approach its surgeons use and why, so you know what recovery to plan for.
Can the ovaries be put back afterwards?
They are not usually moved back. Some women become pregnant naturally with ovaries in the new position, depending on where the ovaries and tubes sit. Where that is not possible, eggs can be collected for IVF. A few surgeons do move the ovaries back, and your team will explain their view.
Will moving my ovaries cause pain later?
Most women have no lasting discomfort. Some notice a dull ache on one side, often around the middle of the cycle, or develop a cyst on a moved ovary. These are usually managed without further surgery. Tell your doctor about any new or worsening pain rather than assuming it is expected.
Should I also freeze eggs or embryos?
It is worth asking. Egg or embryo freezing stores eggs outside the body, so it protects against both radiation and chemotherapy. It needs hormone injections and some time before treatment. Some women do both. Whether there is time depends on how urgently your cancer treatment must start.
Does my husband or family need to come to the consultation?
It is your decision, but many women find it helps to bring the person they will decide with. The conversation covers fertility, menopause and future pregnancy, and there is a lot to take in. A family member can write down the answers while you listen.
Is it covered by Aarogyasri or insurance?
Cover varies. When the procedure is part of an approved cancer treatment plan, schemes such as Aarogyasri, CGHS, ECHS and EHS, and cashless insurers, may treat it as part of that care. Call the helpline with your card or policy details and we will check what applies before you decide.
What should I ask my surgeon before agreeing?
Ask where the ovaries will be placed and how much radiation they are still likely to receive. Ask whether the cancer type makes spread to the ovary more likely, and whether egg freezing is possible in the time available. Also ask how often the surgeon does this operation.
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Sources
- National Cancer Institute — Fertility issues in girls and women with cancer
- American Cancer Society — Fertility and sexual side effects
- Cancer.Net — Dating, sex and reproduction
- NICE — Fertility problems: assessment and treatment (CG156)
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Egg freezing before cancer treatmentProtects eggs from both radiation and chemotherapyUterine transposition: a newer optionAn experimental way to move the womb as wellFertility-sparing surgery in cervical cancerWhere transposition is most often discussedRadiation therapy guideHow pelvic radiation is planned and givenOncofertility SurgeryEvery page in this guide
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