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The relocation of ovaries for their protection in women diagnosed with cancer in the pelvis was mentioned as early as 1958 by McCall et al. At that time, the procedure was termed oophoropexy and considered to be revolutionary, controversial and "cutting edge" fertility preservation. Ovarian function is compromised when damaged during surgery, exposed to radiation, and/or chemotherapy. Chemotherapy has been found to have a highly variable chance of acute ovarian failure. In general, for gynecological malignancies, cervical and uterine cancers are the most likely indications for adjuvant or definitive radiation treatment to the pelvis, but pelvic radiation is also done for Hodgkin's lymphoma, pediatric sarcomas and rectal cancer. Ovarian function is almost guaranteed to be entirely lost without some intervention before pelvic radiation therapy. Ovarian transposition is a relatively simple option that should be considered with all patients at risk for ovarian failure due to radiation.