Fertility Preservation in Cervical Cancer

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Young women with cervical cancer interested in future fertility often face a difficult dilemma. A radical hysterectomy has been the standard approach for many years. Fortunately, this is no longer the case.

Now patients can be treated for their cervical cancer and still maintain fertility. The procedure is called a radical trachelectomy. In this procedure, the cervix is removed but, unlike radical hysterectomy where the uterus is removed along with the cervix, the uterus is kept intact and it's reattached to the vagina so that women can get pregnant afterwards.

Frequently, many women will ask if by undergoing this procedure they're exposed to a higher risk of recurrence or death from this disease. Fortunately, this isn't the case. The recurrence rate and survival is the same or better than for women undergoing radical hysterectomy.

Most women who try to get pregnant after having this procedure will be able to do so spontaneously. Some women will need assisted reproductive technology to become pregnant. The majority of patients who eventually get pregnant also will reach the third trimester and be able to deliver at term.

All women who undergo this procedure require a cerclage placed either at the time of surgery or early in their pregnancy. A cerclage is a suture that's placed in the lower uterus to hold the pregnancy in place. Another important fact is that all women who undergo a radical trachelectomy must deliver by Cesarean section. A number of patients have been able to get pregnant and deliver healthy babies multiple times after undergoing this procedure.

Some problems may arise after having this procedure such as irregular or lack of menstrual cycles, abnormal Pap smears, vaginal discharge or infertility. Fortunately, these are rare complications.

Women should ask their doctors whether they're candidates for this procedure and should seek a consultation with a gynecologic oncologist who's skilled in performing this procedure.

Resources from M. D. Anderson

Listen to Dr. Ramirez talk about the radical trachelectomy procedure

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