I prefer not to do it during performing CS. the genital system is flooded with blood and physiological changes that occur during pregnancy.. I would prefer to postpone it till after puerperal period, if the patient still insist on doing it and I did the necessary investigations.

BRCA1/2 gene status should be known to the best of my knowledge. Around 10 - 15 %  chance of inheritence exists with ovarian cancers in this case.  Screening with annual mammography from age 30 and breast MRI from age 25 for BRCA1 and BRCA2 mutation carriers are suggested by some authors.

Also bilateral salpingo-oophorectomy can be offered to women with a BRCA1 or BRCA2 mutation once they have complete the desired number of children, around 35 - 40 years of age. Youngest age when the ovarian cancer appeared in the family should be questioned and considered.  However, at 33 year old, inducing menopause may adversely effect heart and bone status of the patient seriously and should be decided by a council of the doctors if the patient insists on having the bilateral salpingoophorectomy.  Early menopause may also affect the cognitive function, so if this women is a professional using cognitive functions/decision making processes, this should be taken into account. 

A single physician should not decide on bilateral salpingoophorectomy of a 33 year old patient just by the desire of the patient to the best of my understanding. 

Thank you Abdel Karim M. El Hemaly and Kazim Emre Karasahin  for your input.

I will consider your opinions before making a decision.

The patient is a professional with a need of high cognitive function so that would be a very important point which might affect her decision.

Agree with my colleagues.It is not a correct time to decide. It should be discussed later on with gyne.oncologist present. Thank You.