Laparoscopic Medial Oophoropexy Prior to Radiation Therapy in an Adolescent with Hodgkin's Disease

Abstract

Background Advances in radiation therapy have led to long term survival in young patients with Hodgkin's disease. Oophoropexy may reduce ovarian damage and preserve hormonal production and future fertility. When ovarian ligaments are shortened, incising the serosa parallel to the infundibulopelvic ligaments at laparoscopy permits the completion of a medial oophoropexy. Case An adolescent female underwent a laparoscopic medial oophoropexy prior to radiation therapy for Stage IIIB Hodgkin's disease. Due to shortened ovarian ligaments the ovaries could not be placed behind the uterus without excessive tension. The infundibulopelvic ligaments were sharply dissected off of the lateral pelvic sidewalls eliminating tension on the ligaments and allowing completion of the medial oophoropexy. Twenty-two months after completion of her radiation therapy the patient was normally menstruating and conceived spontaneously. Conclusion Laparoscopic dissection of the infundibulopelvic ligaments allowed for a medial oophoropexy to be performed in an adolescent patient and was associated with return of ovarian function after radiation therapy.