A surgical technique designed to preserve fertility in women undergoing pelvic radiation therapy has been performed for the first time in Canada at the McGill University Health Centre (MUHC). This procedure, known as uterine transposition - developed and performed by Dr. Reitan Ribeiro - offers immense hope to women with colorectal and other pelvic cancers who wish to retain the ability to conceive and carry a pregnancy to term after remission, while reducing the risk of early menopause.
"With the rising incidence of cancer among young women and the trend toward later motherhood, it is becoming essential to consider not only cancer treatment but also patients' quality of life and future plans," explains Dr. Reitan Ribeiro, a gynecologic oncologist at the MUHC and Senior Investigator at the Women's Health Research Unit of the Research Institute of the McGill University Health Centre (The Institute). "Uterine transposition allows patients with pelvic tumours that do not involve the reproductive organs to undergo radiation therapy without having to give up their desire to start or expand a family in the future."
Uterine transposition involves moving the uterus, ovaries and the fallopian tubes upward into the upper abdomen during an initial surgical procedure to protect them from the radiation field during radiation therapy. Once treatment is complete, the reproductive organs are repositioned to their original pelvic location during a second procedure. Performed using minimally invasive techniques, this procedure promotes rapid recovery and does not delay the start of cancer treatment.
Britany Fecteau, a 28-year-old woman treated at the MUHC for Hodgkin's lymphoma in the groin, is the first patient in Canada to undergo this procedure. The initial procedure took place on February 26, 2026, and the second on April 29, 2026, one month after the completion of radiation therapy.
"Receiving a cancer diagnosis at my age was a tremendous shock. Learning that the treatments could also cause me to lose my fertility and put me into early menopause was just as shocking. This surgery allowed me to preserve my ovaries and uterus before radiation therapy, and that means the world to me. As a young mother, knowing that this option exists gave me hope and helped me get through the treatments with a little more peace of mind," says Britany. "I hope my story can help raise awareness of this option for other women facing a similar situation."
Since Dr. Ribeiro developed the uterine transposition technique in 2017 while practising at Erasto Gaertner Hospital in Brazil, more than 45 procedures have been performed worldwide, and six natural pregnancies have been carried to term following the procedure-without the use of assisted reproductive technologies.
"Offering fertility preservation options to young cancer patients is invaluable to them and their loved ones, and is an integral part of our vision for innovative, patient-centred oncological and surgical care," says Dr. Lucy Gilbert, an internationally recognized researcher in gynecological cancers, Director of Gynecologic Oncology Cancer Services at the MUHC and Chair of the Gerald Bronfman Department of Oncology at McGill University. "We are proud to recruit the best experts, such as Dr. Ribeiro, to advance women's health."
Radiation therapy plays a key role in the treatment of many cancers, including colorectal and gynecological cancers. However, even at low doses, radiation inevitably causes irreversible damage when it reaches the reproductive organs. Radiation impairs ovarian reserve and causes uterine atrophy, leading to the loss of reproductive capacity.
Radiation also affects the endocrine function of the ovaries by interrupting estrogen production, which can trigger early menopause.
"Beyond the loss of fertility, damage to the ovaries has significant repercussions on women's physical and psychological health. Early menopause increases the risk of cardiovascular disease and osteoporosis, in addition to causing symptoms such as hot flashes, fatigue and mood swings," notes Dr. Ribeiro, who is also Associate Professor in both the Gerald Bronfman Department of Oncology and the Department of Obstetrics and Gynecology at McGill University. "By preserving ovarian as well as uterine function, this procedure eliminates the risk of premature menopause."