1. ¹Department of Radiology, University of Tokyo Hospital, Tokyo, Japan
2. ²Department of Cell Therapy & Transplantation Medicine, University of Tokyo Hospital, Tokyo, Japan
3. ³Department of Health Sciences, Oita University of Nursing and Health Sciences, Oita, Japan
4. ⁴Department of Gynecology, University of Tokyo Hospital, Tokyo, Japan

Correspondence: Dr K Nakagawa, Department of Radiology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan. E-mail: nakagawa-rad@umin.ac.jp

Received 16 June 2005; Revised 21 November 2005; Accepted 25 November 2005; Published online 30 January 2006.

Abstract

The purpose of this study was to evaluate the possibility of preserving ovarian function by ovarian shielding to reduce the irradiation dose in total body irradiation (TBI). The subjects in the study were females aged less than 40 years, who were undergoing allogeneic hematopoietic stem cell transplantation using a TBI-based regimen and who desired to have children after transplantation. For ovarian shielding, abdominal computed tomography (CT) and skin marking were performed in both the supine and prone positions, prior to the TBI. A pair of columnar blocks was placed just above the patient's body. Thus far three patients have been treated. The serum estradiol level decreased to an undetectable level (<8.5 pg/ml) after transplantation and the follicle-stimulating hormone (FSH) level increased above 90 mIU/ml in all patients and they became amenorrheic. However, regular menstruation recovered in patients no. 1 and 2 about 800 and 370 days after transplantation, respectively, with a decrease in the serum FSH level. Menstruation did not recover in patient no. 3, and serum estradiol was transiently detected above 20 pg/ml. The preservation of ovarian function was made possible by ovarian shielding. However, a longer follow-up is needed to know if normal pregnancy and delivery can occur.