Ovary is necessary to the health of uterus.

We would like to express great thanks for the interest and comments on our review. We agree with Dr. Martinelli et al.’s opinion about the importance of the uterus with regards to pregnancy outcomes following radiation treatment [1]. Total body irradiation (TBI) or pelvic radiation can indeed affect the uterus, causing side effects like reduced uterine volume, endometrial injury, vascular impairment and myometrial fibrosis and thinning, as well as permanent damage dependent on dosage [2]. Therefore, it may ultimately affect the status of the uterus and lead to decreased pregnancy rates and complications during pregnancy. Currently, there is no clinically applicable way to protect the function of the uterus. Emerging options include uterus transplantation [3] or surrogacy for patients who have pregnancy complications after pelvic irradiation. Concern for uterine health and function as it relates to pregnancy is part of the current oncofertility discussion at National Physician Cooperative and Global Partner sites [4]. Thus we concur with the authors that personalized counseling for woman should include a multidisciplinary oncofertility team that discusses all aspects of treatment-related issues. We also agree that the goal of oncofertility interventions is the ability to protect as many reproductive functions as possible (pituitary, ovarian, fallopian tube, uterus, cervix) and that biological parenting with high quality gametes.