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RecruitingNCT07419490UOT WPXRTUpdated Jun 24, 2026

Utero-ovarian Transposition in Patients With Pelvic Malignancies Undergoing Whole Pelvic Radiotherapy

An interventional study of Uteroovarian transposition in Colorectal (Colon or Rectal) Cancer, Pelvic Malignancies and Oncofertility, sponsored by University of South Florida. Recruiting at 1 site in United States. Open to female participants aged 18 Months to 40 Months. Per ClinicalTrials.gov, last updated 2026-06-24.

Sponsored by University of South Florida · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Apr 2026; still recruiting 6 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
26
Allocation
Not applicable
Ages
18 Months to 40 Months
Sex
Female
01

Study summary

This study is designed as a Phase I clinical trial enrolling female patients aged 18-40 years who have been diagnosed with pelvic malignancies requiring whole pelvic external radiation therapy (WPXRT) and who express interest in preserving fertility and ovarian function.

The trial's primary objective is to assess the feasibility and safety of uterine and ovarian transposition (UOT). Premenopausal women under the age of 40 will undergo UOT using a novel minimally invasive approach.

Feasibility and safety will be evaluated through standardized postoperative assessments, including:

(A) success in mobilizing and repositioning the uterus, ovaries, and fallopian tubes while maintaining vascular integrity; (B) documentation of surgical complications; (C) monitoring the timeliness and adherence to planned WPXRT.

To enhance safety and optimize outcomes, intraoperative imaging with indocyanine green fluorescence and Doppler ultrasonography will be employed.

Short-term success will be defined by technical success in repositioning the uterus and ovaries with preserved vascular integrity, absence of major surgical complications, and timely initiation and completion of WPXRT.

Long-term success will be evaluated by the preservation of fertility.

The study's primary objective is also to evaluate surgical, reproductive, and quality-of-life outcomes following UOT. This objective will determine the procedure's efficacy in preserving ovarian and menstrual function and its potential to support future pregnancies.

Endpoints include:

(A) maintenance of normal premenopausal levels of FSH, LH, AMH, and estradiol at defined postoperative intervals; (B) assessment of menstrual timing, regularity, and characteristics to document return of ovulatory cycles; (C) evaluation of uterine integrity and reproductive potential using pelvic ultrasonography; (D) comprehensive evaluation of patient quality of life encompassing physical, emotional, sexual, and reproductive well-being.

These measures will inform optimization of surgical techniques and provide a foundation for scaling the procedure to a broader population in future studies.

Read the detailed description

This is a phase I study aimed to evaluate feasibility and safety of utero-ovarian transposition (UOT) in young women undergoing whole pelvic radiation therapy (WPXRT) for treatment of a colorectal or other cancers localized to the pelvis. By comprehensively evaluating real-world outcomes for women undergoing this procedure, the proposed work will lay the groundwork necessary to establish UOT as a viable option for fertility preservation and survivorship for this unique patient population. Rigorous inclusion and exclusion criteria will ensure the selection of appropriate candidates, who will undergo a minimally invasive transposition of their cervix, uterus, tube and ovaries outside the planned radiation fields, thus sparing transposed organs from radiation exposure. Following a brief recovery, the radiation oncology team will proceed with WPXRT to treat each patient's cancer. If chemotherapy is indicated, it will be completed at this time, prior to the second procedure. After completing radiation therapy and/or chemotherapy, the uterus and adnexa will be surgically returned to their normal anatomical position.

This study will assess surgical outcomes for enrolled subjects undergoing this care plan, assess quality of life and the preservation of fertility and uterine receptivity by multiple objective measures.

Throughout the study, patients will be closely monitored for perioperative outcomes, including surgical complications, hospital stay, and quality of life. Patterns of menstruation, as well as levels of key hormones routinely used to assess fertility (FSH, LH, AMH, and estradiol) will be measured at key time points.

Successful UOT will be defined as the ability to complete the procedure and successfully restore a viable uterus and adnexa capable of supporting normal menstruation and fertility post-radiation therapy.

The resumption of menstrual cycles for six months following the procedure will be evaluated. Quality of life will be evaluated at multiple steps as women undergo the proposed procedures as well as throughout the planned 6 months follow up window.

Data generated by this pilot study will provide critical insights into the feasibility, safety, and potential benefits of UOT as a fertility-preserving and ovarian function-conserving option for patients with pelvic malignancies undergoing WPXRT. Moving forward, data from this study will be used not only to build out the programmatic and clinical infrastructure needed to further evaluate the efficacy of UOT, but also to overcome roadblocks to its successful clinical implementation in the future.

02

Conditions studied

  • Colorectal (Colon or Rectal) Cancer
  • Pelvic Malignancies
  • Oncofertility

Keywords

  • uterine transposition
  • utero-ovarian transposition
  • oncofertility
  • pelvic radiation
  • pelvic malignancies
  • rectal cancer
  • colorectal malignancies
  • fertility preservation
03

In context

Colonic Neoplasms

1,432 studies on the registry are indexed under Colonic Neoplasms; 357 are open to participants now.

This study's planned enrollment of 26 is below the median of 90 across 1,034 interventional studies indexed under Colonic Neoplasms.

Browse Colonic Neoplasms studies →

Lead sponsor

University of South Florida is the lead sponsor of 333 studies on the registry; 63 are open to participants now.

Of its 17 completed or terminated interventional studies of FDA-regulated products, 4 (24%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Months to 40 Months
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  1. Age: Women 18 - 40 years of age who wish to preserve their fertility.
  2. Malignancy: Diagnosis of pelvic malignancies that require radiotherapy, including:

    1. Colon and rectal cancer with tumors.
    2. Anal cancer.
    3. Other pelvic malignancies that require administration of WPXRT.
  3. Desire for Fertility Preservation: The patient expresses a clear desire to preserve fertility and the ability to carry a pregnancy in the future.
  4. Preoperative Ovarian Function: The patient must have normal ovarian function, demonstrated by specific hormonal values, including:

    1. Follicle-Stimulating Hormone (FSH): \<10 IU/L
    2. Luteinizing Hormone (LH): within normal reference range for reproductive age (typically 1.5-8 IU/L in the early follicular phase).
    3. Anti-Müllerian Hormone (AMH): >1 ng/mL
    4. Estradiol (E2): within the normal range for the follicular phase (usually 30-120 pg/mL).
  5. No Distant Metastasis: Absence of metastatic disease confirmed by imaging (CT, MRI, or PET scans).
  6. Body Mass Index (BMI) \< 35.
  7. Signed Informed Consent.

Exclusion criteria

Exclusion Criteria:

  1. Advanced Cancer Stage: Patients with locally advanced or metastatic disease.
  2. Significant Uterine Pathology: Presence of large uterine fibroids, adenomyosis, or other intrauterine pathologies that would complicate the procedure or future pregnancy.
  3. Poor General Health or Comorbidities: Severe medical conditions that contraindicate surgical intervention, that include but not limited to:

    • Cardiovascular Disease:

      1. Recent (within 6 months) myocardial infarction (MI).
      2. Ejection fraction (EF): EF \<30%.
      3. Uncontrolled hypertension: Systolic BP >180 mmHg or Diastolic BP >110 mmHg prior to surgery.
      4. Severe aortic stenosis: Valve area \<1 cm² with symptomatic status.
    • Uncontrolled Diabetes Mellitus:

      1. Hemoglobin A1c (HbA1c) > 9%
      2. Persistent fasting glucose >250 mg/dL preoperatively despite optimization.
    • Severe Respiratory Diseases:

      1. Forced expiratory volume (FEV1): \<50%.
      2. Oxygen saturation: Resting SpO₂ \<88% on room air without supplemental oxygen.
      3. CO2 retention: PaCO₂ >50 mmHg.
    • Connective Tissue Disorders:

      1. Severe systemic lupus erythematosus (SLE): Active lupus nephritis with GFR \<30 mL/min.
      2. Scleroderma with severe pulmonary hypertension or FVC \<50% predicted.
      3. Rheumatoid arthritis with severe cervical spine instability (atlantoaxial subluxation).
    • Severe Inflammatory Bowel Disease (IBD):

      1. Severe Crohn's or ulcerative colitis flares with C-reactive protein (CRP) >10 mg/L and hypoalbuminemia (Albumin \<2.5 g/dL).
      2. Severe malnutrition: BMI \<18.5 kg/m² or Prealbumin \<10 mg/dL
    • Steroid dependency:

      1. Chronic steroid use (>20 mg prednisone daily) with no feasible taper pre-surgery.
  4. Prior Pelvic Radiotherapy.
  5. Prior history of systemic chemotherapy and immunotherapy that resulted in significant toxicity and residual deficit.
  6. Pregnancy: Patients who are currently pregnant are excluded from consideration for uterine transposition.
  7. Unsuitable for Ovarian Function Preservation: Women with signs of poor ovarian reserve, including:

    • FSH: >10 IU/L
    • AMH: \<1 ng/mL
    • Estradiol: outside normal range.
  8. Non-Candidate for Fertility: Patients with contraindications to future pregnancy, such as severe uterine abnormalities or significant risk for pregnancy-related complications.
  9. Body Mass Index (BMI) ≥35.
  10. Absence of One of the Gonadal Vessels.
  11. Other unlisted conditions or diagnoses that, in the opinion of the primary investigator, render the patient an unsuitable candidate for uteroovarian transposition.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
26 participants (estimated)

Study arms

  • Experimental
    Uteroovarian transposition arm

    Our study population includes premenopausal women 18-40 years old who are diagnosed with pelvic malignancies, such as rectal, colorectal cancer, and other pelvic malignancies that require radiotherapy and wish to preserve fertility and ovarian function. Subjects will be interested in improving their quality of life and reproductive outcomes without the need to undergo additional reproductive endocrinology interventions. Eligible patients will undergo UOT using a novel minimally invasive approach.

    Procedure: Uteroovarian transposition

Interventions

  • ProcedureUteroovarian transposition

    Uteroovarian transposition involves temporarily relocating the uterus, both ovaries and fallopian tubes outside the planned radiation field. Once WPXRT is complete, a second surgery is performed to return these organs to their natural position in the patient's pelvis.

    Also known as: uterine transposition

06

What researchers measure

Primary outcomes

  1. Success of uterine transposition

    Success of uterine transposition (feasibility) will be defined as the percentage of cases in which the uterus, ovaries, and fallopian tubes are successfully mobilized and repositioned as planned without the need for intraoperative conversion. Unit of Measure: Percentage of participants (%) Time Frame: up 30 days postsurgery.

    Time frame: From enrollment to completion of surveillance/monitoring at 52 weeks

Secondary outcomes

  1. Postoperative Complications

    Postoperative complications will be monitored. All complications will be graded according to the Clavien-Dindo classification system. Unit of Measure: Number of participants with complications.

    Time frame: From enrollment to 4 weeks postsurgery

  2. Menstrual Function

    Menstrual function will be evaluated by assessing the return of menses, cycle regularity, and ovulatory characteristics through a standardized postoperative questionnaire. Unit of Measure: Percentage of participants (%)

    Time frame: From enrollment then at 4, 8, 12 weeks and 52 weeks after surgery

  3. Hormonal Function: Follicle-Stimulating Hormone (FSH)

    Hormonal Function will be evaluated by measuring serum levels of FSH Unit of Measure: Hormone concentration: IU/L

    Time frame: From enrollment then at 4, 8, 12 weeks and 52 weeks after surgery

  4. Hormonal Function: Luteinizing Hormone (LH)

    Hormonal Function will be evaluated by measuring serum levels of LH. Unit of Measure: Hormone concentration: IU/L.

    Time frame: From enrollment then at 4, 8, 12 weeks and 52 weeks after surgery

  5. Hormonal Function: Anti-Mullerian Hormone (AMH)

    Hormonal Function will be evaluated by measuring serum levels of AMH. Unit of Measure: Hormone concentration: IU/L.

    Time frame: From enrollment then at 4, 8, 12 weeks and 52 weeks after surgery

  6. Hormonal Function: Estradiol

    Hormonal Function will be evaluated by measuring serum levels of estradiol. Unit of Measure: Hormone concentration: ng/mL.

    Time frame: From enrollment then at 4, 8, 12 weeks and 52 weeks after surgery

  7. Quality of Life: FSFI survey

    Quality of life will be measured using the FSFI survey. Unit of Measure: FSFI total score.

    Time frame: At enrollment then at 12 weeks and 52 weeks after surgery

  8. Quality of Life: EORTC QLC-C30

    Quality of life will be measured using the EORTC QLQ-C30. Unit of Measure: EORTC QLQ-C30 score.

    Time frame: At enrollment then at 12 weeks and 52 weeks after surgery

07

Study locations

1 of 1 sites recruiting
  • Tampa General Hospital
    Tampa, Florida 33606, United States
    • Jennifer Childress, RN, CCRP · Contact · jchildress@tgh.org · 813-844-1053
    • Vaagn Andikyan, MD · Contact · andikyan@usf.edu · 813-844-4554
    • Vaagn Andikyan, MD · Principal investigator
    Recruiting
08

References and documents

Publications

  • Apelian S, Vest A, Yasukawa M, Wellcome J, Kohut A, Imudia AN, Tuli R, Anderson ML, Rutherford T, Andikyan V. Uterine Transposition for Fertility Preservation and Ovarian Conservation in Patients Undergoing Pelvic Radiotherapy. Obstet Gynecol. 2025 Nov 1;146(5):679-689. doi: 10.1097/AOG.0000000000005954. Epub 2025 Jul 3. PubMed 40609092 ↗
  • Ribeiro R, Baiocchi G, Moretti-Marques R, Linhares JC, Costa CN, Pareja R. Uterine transposition for fertility and ovarian function preservation after radiotherapy. Int J Gynecol Cancer. 2023 Dec 4;33(12):1837-1842. doi: 10.1136/ijgc-2023-004723. PubMed 37898483 ↗
  • Ribeiro R, Rebolho JC, Tsumanuma FK, Brandalize GG, Trippia CH, Saab KA. Uterine transposition: technique and a case report. Fertil Steril. 2017 Aug;108(2):320-324.e1. doi: 10.1016/j.fertnstert.2017.06.016. Epub 2017 Jul 8. PubMed 28697913 ↗

Individual participant data

Plan to share: Yes — Upon reasonable request, deidentified clinical data generated during the study will be available from the principal investigator, Dr. Vaagn Andikyan.

Supporting information: Study protocol, Sap, Icf

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 24, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07419490
Lead sponsor
University of South Florida
Responsible party
Vaagn Andikyan (Associate Professor, University of South Florida) — Principal investigator
First posted
Feb 19, 2026
Start date
Apr 1, 2026
Primary completion
Jun 2030 (estimated)
Completion
Jun 2031 (estimated)
Last update
Jun 24, 2026

Study contacts

Brittani Powell, MPH, CCRP
Contact
RSCH-IRB@usf.edu
(813) 974-5638
Jennifer Childress, RN, CCRP
Contact
jchildress@tgh.org
813-844-1053
Vaagn Andikyan
principal investigator · USF Health Morsani College of Medicine

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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