Rebeca Delgado, a 36-year-old Spanish woman, faced a difficult diagnosis when she was told that her locally advanced colorectal cancer required chemotherapy and radiotherapy that would potentially render her infertile and induce early menopause due to the proximity of the treatment to her uterus and ovaries. Despite not having considered motherhood seriously before, the doctors at Barcelona’s Hospital del Mar presented her with an experimental option to preserve her fertility through uterine autotransplantation. This innovative procedure involved temporarily moving her uterus and ovaries to the abdominal cavity to shield them from the effects of cancer treatment.
Delgado became the first woman in Spain to undergo uterine autotransplantation, a rare surgery that has only been performed on a few individuals worldwide. The procedure, pioneered by a Brazilian surgeon, was initially used for gynecological tumors but has now been extended to cases of locally advanced rectal cancer. The technique involves two stages: the initial surgery relocates the reproductive organs away from the radiation zone, while the second surgery restores them to their original anatomical position after cancer treatment.
The complexity of the procedure lies in preserving the blood supply to the uterus through careful vascular manipulation to ensure its viability. Delgado underwent the first part of the surgery in November 2023, relocating her uterus and ovaries to the abdominal region to protect them during radiotherapy. Subsequent treatments were administered to suppress ovarian function and induce a temporary pseudo-menopausal state to prevent endometrial proliferation and menstruation.
Following her cancer treatment, Delgado underwent a second surgery in June to reposition her reproductive organs and remove any remaining tumor tissue. Despite requiring the removal of a portion of her intestine due to tumor location, her uterus remained intact and functional. The success of the procedure depends on careful patient selection and optimal general health to avoid compromising oncological outcomes.
While uterine autotransplantation offers hope for preserving fertility in select cancer patients, its application is limited to specific tumor types and localized cancers. A study of eight cases reported successful preservation of the uterus in six patients, with two experiencing complications leading to uterine necrosis or cancer-related mortality shortly after the procedure.
Delgado’s journey highlights the intersection of cutting-edge medical interventions with the human desire for parenthood in the face of cancer diagnosis. Her decision to undergo uterine autotransplantation reflects a growing trend towards fertility preservation in female cancer patients, offering new possibilities for reproductive health and family planning in the context of oncological care.