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At 28, Britany Fecteau was told by doctors that treatment for Hodgkin’s lymphoma would mean the loss of her fertility, but thanks to an experimental procedure her reproductive organs were saved. Andrej Ivanov/The Globe and Mail
Britany Fecteau’s story begins, as so many of these stories do, when she found a lump.
She was taking a bath last fall when she felt it on her thigh. She knew it hadn’t been there before.
After a whirlwind of scans and biopsies, Ms. Fecteau was diagnosed several months ago with Hodgkin’s lymphoma. The cancer was also in her groin, next to one of her ovaries.
Even as she was absorbing the news, Ms. Fecteau, 28 at the time, had to consider how she would explain the illness to her six-year-old son. “I found it really hard,” she said. “It’s not something you expect to go through, especially not at my age.”
That wasn’t all. The first course of treatment would be radiation to her pelvis, and as a doctor told her, it would mean the loss of her fertility. “It’ll send you into menopause, and then your uterus – it’ll all be over,” she recalled the doctor explaining. “You won’t be able to have any more children.”
But this is where Ms. Fecteau’s story diverges from other stories like it.
In February, Ms. Fecteau became the first Canadian to undergo uterine transposition, a minimally invasive procedure that temporarily shifts the uterus, fallopian tubes and ovaries to the top of the abdomen, out of radiation’s harmful way. A month after her pelvic radiation treatment was finished, a second surgery in late April put her reproductive organs back in place.
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Ms. Fecteau became the first Canadian to undergo uterine transposition. Andrej Ivanov/The Globe and Mail
Although Ms. Fecteau won’t know for certain unless she tries, she should be able to conceive naturally and carry another baby, unlike many young cancer survivors who must rely on in vitro fertilization or surrogacy to grow their families.
“It’s such a big deal,” said Lucy Gilbert, director of gynecologic oncology at McGill University Health Centre (MUHC,) where Ms. Fecteau was treated.
MUHC announced Ms. Fecteau’s milestone case on Wednesday, hoping to let other Canadian oncologists and patients know a new fertility-saving option is available.
“The burdens on doctors are very, very heavy day to day, and if they don’t hear of it, they just arrange the radiation,” Dr. Gilbert explained. “Then there’s no way back.”
That irreversible situation could become more common, Dr. Gilbert added, as more Canadian women put off having babies , and as rates of certain cancers, including colorectal cancer , rise in younger patients. The rectum is close enough to the female reproductive system that radiating a tumour there would irrevocably damage the uterus and ovaries.
More than 45 uterine transpositions have been performed on women elsewhere in the world since Brazilian gynecologic oncology surgeon Reitan Ribeiro pioneered the technique nearly a decade ago. At least six went on to have babies, according to MUHC.
Dr. Ribeiro operated on Ms. Fecteau.
MUHC recruited him in 2024. It wasn’t a hard sell for Dr. Ribeiro, who described Montreal as his favourite city in the world. He visited five times before the offer came from MUHC, twice on “baby moons” while his wife was pregnant with their daughter and son, now 9 and 6.
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Uterine transposition is not an especially complicated procedure, Dr. Ribeiro explained in an interview.
His innovation was to combine two long-standing operations: Ovarian transposition, which temporarily shifts the ovaries out of the pelvic radiation field to keep women from being kicked into premature menopause, and radical trachelectomy, a surgery where the cervix is removed and the uterus is stitched to the vagina.
If the ovaries could be moved, and the uterus detached from its usual home and later sewn back in place, why not do both to preserve the fertility of women undergoing pelvic radiation?
“Many of the doctors who I spoke to about it, they all said the same thing: ‘How didn’t I come up with this idea before? I mean, it is so obvious,’” Dr. Ribeiro said.
He performed the first uterine transposition in 2017 on a 26-year-old woman with rectal cancer at Erasto Gaertner Hospital in Curitiba, a city in southern Brazil.
He went on to lead a study of the procedure in eight patients, seven with rectal cancer and one with pelvic liposarcoma. Six of the women had their uteruses saved, and two went on to conceive naturally and deliver babies via C-section. (One of the eight died of cancer shortly after uterine transposition, while the remaining patient’s uterus couldn’t be saved, but one of her ovaries survived.)
In his early cases, Dr. Ribeiro attached the uterus to the belly button, providing him an opening to examine the repositioned uterus and allowing women to continue having their periods. Now he prescribes medication to pause menstruation until…
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