Having Children After Cervical Cancer
Of all the side effects of cervical cancer treatment, fertility issues or the loss of reproductive organs can be one of the hardest to accept. If you're of childbearing age and want a family, your ability to conceive and carry a baby might be your most pressing concern.
While cervical cancer radiation treatment and surgery often result in the permanent damage or removal of the cervix, uterus and sometimes the ovaries, fertility-sparing options are available for women diagnosed in the early stages of the disease, when cancer cells are confined to the cervix.
Before your cervical cancer treatment starts, ask your doctor or fertility specialist about your options for having children.
Cold knife cone biopsy
If your cancer treatment involves a cold knife cone biopsy, getting pregnant and carrying a baby full term is likely possible. With this procedure, only the portion of the cervix where the cancer is located is removed. The cervix is the lower part of the uterus (womb) that opens at the top of the vagina. If the outer edges of the biopsy contain healthy, non-cancerous cells, the cancer is removed without full removal of the cervix, leaving the reproductive organs intact.
If you require radiation treatment but your ovaries do not need to be treated, one or both of your ovaries may be surgically repositioned higher in the abdomen and out of the field of radiation. This is called ovarian transposition (oophoropexy). By separating the ovaries and fallopian tubes from the uterus and attaching them to the abdominal wall, a shield can be used to protect them from harmful radiation. After treatment, you might need to have your ovaries repositioned again, and it may be possible to conceive.
With a radical trachelectomy, most of the cervix is removed, but the remainder of the uterus is left in place. While not all cervical cancer patients qualify for this procedure, it is an option for some women in the early stages. After this procedure, it should be possible to become pregnant, but if there is significant scarring from the procedure, then intrauterine insemination (IUI) or in-vitro fertilization (IVF) with embryo transfer may be needed. You should be followed closely by an obstetrician during the pregnancy. The risk of miscarriage, delivery by c-section, and premature birth are high. Your doctor can discuss these risks with you.
Embryo preservation and surrogacy
When cervical cancer is discovered at a late stage, treatment often includes a hysterectomy, a surgical procedure that removes all of the uterus and cervix. Without these organs, carrying a biological child is not possible, but there is still hope.
Assisted reproductive technology, oocyte preservation (egg freezing) and IFV with a surrogate are options that can result in a biological child. In-vitro fertilization is a method of assisted reproduction that involves removing eggs from the body and combining eggs and sperm (in a lab) to form embryos. The resulting embryos are then placed into a surrogate uterus in the hopes of achieving a pregnancy. IVF is a well-established and effective treatment that can provide cancer survivors the chance at biological parenthood.
Before undergoing cervical cancer treatment, ask your doctor and fertility specialist about ways to preserve your fertility. Even if you're already a parent or aren't sure you want children, consider discussing these options with your healthcare provider. They may have the answers to your current or future dreams.