Preserving Fertility in Adolescent Girls and Young Women Requiring Craniospinal Irradiation: A Case Report and Discussion of Options to Be Considered Prior to Treatment.

Craniospinal irradiation (CSI) is associated with infertility risk for adolescent/young adult women. We explore two methods of reducing ovarian exposure: oophoropexy (surgical removal of the ovaries from the path of the X-ray beam) and proton therapy (to allow the beam to stop without exposing the ovaries/uterus). In the case discussed, oophoropexy followed by X-ray CSI reduced ovarian dose to that at which 50% of oocytes are expected to survive, and the patient appears to have viable oocytes; this technique did not reduce uterine dose. Proton therapy would have eliminated the ovarian and uterine dose and the need for oophoropexy.