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Moving the ovaries before pelvic radiation | CION Cancer Clinics
Ovarian transposition is a short operation that moves one or both ovaries up and out of the pelvis before radiotherapy, so the radiation mostly misses them. It is done to keep the ovaries making hormones and avoid a sudden early menopause in younger women. It does not suit everyone, it does not always work, and it does not on its own protect the ability to carry a pregnancy. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · 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?
- Who might be offered it, and who is it not for?
- What happens during the operation?
- What can it protect, and what can it not?
- What do families believe, and what is true?
- What do the medical words mean?
- What should you ask, 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 short operation that moves one or both ovaries up and out of the pelvis, away from where radiation will be aimed. The goal is to keep the ovaries making hormones, so that a younger woman does not go into a sudden, early menopause because of pelvic radiotherapy.
Why the ovaries need protecting
Radiation to the pelvis is used for cervical cancer and some other cancers low in the tummy. The ovaries normally sit right beside the womb, inside that area. Even a modest amount of radiation can stop them working. When they stop, periods end and the body loses oestrogen, which brings hot flushes, vaginal dryness and, over years, thinner bones.
What moving them changes
The surgeon frees each ovary on its blood supply and fixes it higher, to the side wall of the tummy. Small metal clips mark the new position so the radiation team can see it on planning scans and shape the beams around it. The ovary keeps working where it is placed, as long as its blood supply stays healthy.
This operation mainly protects hormones. It does not on its own protect the ability to carry a pregnancy.Who it is for
Who might be offered it, and who is it not for?
Your team weighs the cancer, your age and the treatment plan. These are the situations they are thinking about.
Before chemoradiation
When radiation with chemotherapy is the main treatment instead of surgery, the ovaries may be moved in a separate keyhole operation a little before treatment starts.
During a radical hysterectomy
If the surgeon thinks radiation may be needed afterwards, the ovaries can be kept and moved during the same operation. If radiation turns out not to be needed, they simply stay where they were placed.
Usually not offered
- After menopause, when the ovaries have already stopped
- When the ovaries may already hold cancer
- When the cancer has spread widely in the tummy
The type of cancer matters
Some types spread to the ovaries more often than others. Your report names the type. Your team uses it to decide whether keeping the ovaries is sensible.
Chemotherapy can also affect the ovaries. Moving them does not shield them from that.Not sure whether this applies to you?
Ask an oncologistWhat happens
What happens during the operation?
Before the day
You will have blood tests and an anaesthetic check. If egg or embryo freezing is being considered too, that is discussed first, because the timing has to fit around your cancer treatment.
Under general anaesthetic
When done on its own, it is usually keyhole surgery through a few small cuts. The surgeon may also check the lymph nodes and the lining of the tummy while inside.
Moving and marking
Each ovary is freed, lifted on its blood vessels and stitched high on the side wall. Metal clips are placed so the radiation team can find it on scans.
Recovery and radiation
Many people go home within a short stay. Radiation planning follows, using the clips to keep the beams away from the ovaries where possible.
Side by side
What can it protect, and what can it not?
What it may help with
What it does not change
Keeping the ovaries making hormones after radiation
The effect of chemotherapy on the ovaries
Avoiding a sudden early menopause
Radiation damage to the womb, which usually rules out carrying a pregnancy
Keeping eggs that might later be collected
The need to discuss egg or embryo freezing separately
Protecting bone and heart health linked to oestrogen
The chance that the ovaries stop working anyway, in time
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Commonly believed
What do families believe, and what is true?
"If the ovaries are moved, she can still have a baby."
Not by carrying a pregnancy, in most cases. A radical hysterectomy removes the womb, and pelvic radiation usually damages it. The operation protects hormones. Any hope of a genetic child depends on egg or embryo freezing and specialist fertility advice.
"Once they are moved, the ovaries are safe for sure."
Moving them lowers the radiation they receive, but not always to nothing. Scattered radiation, chemotherapy and changes to the blood supply can still stop them working. It improves the odds; it is not a promise.
"Keeping the ovaries will make the cancer come back."
For the cancers where transposition is offered, the ovaries are rarely involved, and the team only suggests keeping them when they judge that risk to be low. If your cancer type raises it, they will say so.
"It is a big extra operation that delays treatment."
It is usually a short keyhole procedure, timed so that cancer treatment starts as planned. If it would cause a delay the team thought unsafe, they would not recommend it.
Words you may hear
What do the medical words mean?
- Oophoropexy
- Another name for fixing an ovary in a new position. You may see it on the consent form.
- Lateral transposition
- Moving the ovary up to the side wall of the tummy, the most common position chosen.
- Premature ovarian insufficiency
- The ovaries stopping work well before the usual age of menopause. This is what the operation tries to avoid.
- AMH (anti-Müllerian hormone)
- A blood test that gives a rough idea of the egg reserve. It is not a test of whether you can become pregnant.
- Hormone replacement therapy (HRT)
- Medicines that replace oestrogen if the ovaries stop. Whether it suits you depends on your cancer, and your oncologist decides.
Being straight with you
What should you ask, and what can this page not tell you?
This page cannot tell you whether moving your ovaries is right for you. That depends on the type and stage of the cancer, your age, whether you have reached menopause, and whether surgery, radiation or both are planned. The decision belongs to you and your treating team together.
Questions worth taking to the appointment
Ask whether radiation is definitely planned, or only possible. Ask whether your type of cancer makes spread to the ovaries more likely. Ask how much radiation the ovaries are still expected to receive after moving. Ask whether chemotherapy will affect them anyway. Ask whether a referral to a fertility specialist makes sense before treatment starts, and how long that would take.
What can happen later
A moved ovary can form fluid-filled cysts, which sometimes cause pain on one side of the tummy. Rarely, it needs another procedure. Because the ovary sits higher, any later egg collection is done through the tummy rather than the vagina. Ask who will follow up your hormone levels and symptoms after treatment ends.
If you are unsure what your team has proposed, call the helpline. We will help you reach a surgical oncologist who can explain it.Questions we are asked
Common questions about ovarian transposition
Does moving the ovaries always stop early menopause?
No. It improves the chance that the ovaries keep working, but some women still go into menopause. Scattered radiation, chemotherapy, age and changes to the blood supply all play a part. Your team can explain what they expect in your situation, and what support is available if the ovaries do stop.
Can I get pregnant after ovarian transposition?
Carrying a pregnancy is usually not possible after a radical hysterectomy or pelvic radiation, because the womb is removed or damaged. Eggs from protected ovaries might be collected later. If a genetic child matters to you, ask for a fertility specialist before treatment starts, not after.
Is it done as a separate operation?
It can be. Before chemoradiation it is usually a short keyhole operation on its own. If you are having a radical hysterectomy and radiation might follow, it is done during that same operation. Your surgeon will explain which applies and how it fits the treatment timetable.
Will I feel the ovaries in their new place?
Most women do not. Some notice an ache on one side of the tummy at certain times of the month, and occasionally a cyst forms and causes pain. Mention any new or lasting pain at follow-up, so it can be checked with an ultrasound.
Why are metal clips left inside?
The clips show up on scans and mark exactly where each ovary now sits. The radiation team uses them to plan the beams around the ovaries. They are small, stay in place and do not usually cause problems. Tell anyone arranging an MRI that you have them, and they will check.
My mother is past menopause. Should she ask for this?
It is generally not offered after menopause, because the ovaries have already stopped making hormones and there is nothing for the operation to protect. Her team may recommend removing the ovaries instead, depending on the cancer. That is a question to ask them directly.
Can I take hormone replacement if the ovaries stop anyway?
Many women treated for the common types of cervical cancer can, but it depends on the type of cancer and your health. Only your oncologist can say whether HRT suits you. Do not start any hormone medicine on your own, including those bought over the counter.
Does it add to the cost of treatment?
It can, particularly when done as a separate operation. Aarogyasri, CGHS, ECHS, EHS and cashless insurance may cover it when it is part of an approved cancer treatment plan. Call the helpline with your card or policy details and we will help you check your cover.
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Sources
- National Cancer Institute — Fertility issues in girls and women with cancer
- Cancer Research UK — Treatment for cervical cancer
- Macmillan Cancer Support — Cervical cancer
- NHS — Early menopause
- American Cancer Society — Fertility and sexual side effects
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
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