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Irradiated Uterus & Pregnancy Issues

Overview

Can the Irradiated Uterus Sustain a Pregnancy? A Literature Review

M. T. Guerrero Urbano and Diana M. Tait,

Department of Clinical Oncology, Royal Marsden Hospital, Sutton, UK

Abstract

A significant number of adult pre- menopausal women are offered pelvic radical radiotherapy as part of the management of their malignancy.

Advances in human reproductive research are making pregnancy a possibility for these women, but ovarian function, however, is not the only requirement for establishing and maintaining a pregnancy that will result in the delivery of a normal infant.

The processes of implantation, fetal and placental development and labour require normal cervical structure and function. Radiation induces acute and late changes in the uterus that have a permanent impact.

This article aims to summarise the published data on this complex subject. To date, the majority of reports of successful pregnancies refer to women who had hemi-pelvis or abdominal irradiation suggesting that partial volume irradiation of the uterus may not preclude pregnancy.

However, with the current available information, women receiving a radical dose of radiotherapy to the whole uterus are very unlikely to have a successful pregnancy even if ovarian function is maintained.

Systematic studies and, in particular, studies looking at modern radiotherapy techniques are required, as well as a register of pregnancies and outcomes to be able to provide answers for this group of patients.

Clinical Oncology Volume 16, Issue 1 , February 2004, Pages 24-28

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