Cervical cancer and fertility

The shock of diagnosis to fear of a life without children, women react in different ways to being told they have cervical cancer. For some the most important thing is to have treatment and stay alive, others are preoccupied with the fact they may be unable to have children.

Unfortunately cervical cancer treatment for most women means they won’t be able to get pregnant. With cervical cancer affecting some quite young women, dealing with the emotional issue of infertility as well as the diagnosis of cancer can be overwhelming.

Talk about the options

Before treatment you’ll have the chance to talk to your doctors about how you feel and what you want and they’ll be able to tell you what your options are.

If you have a hysterectomy, which is having your womb removed, or if you have radiotherapy which prevents your ovaries from working you won’t be able to get pregnant after treatment.

However, you may be able to store your embryos or have your eggs frozen and stored for use in the future by a surrogate.

Early stage

There is hope - in some cases, women with early cervical cancer may still be able to get pregnant and have children. There are treatments which help preserve fertility but they’re not right for everyone.

If your cervical cancer is at a very early stage you may be able to have a radical trachelectomy, a cone biopsy or a LLETZ. With these treatments having a baby may still be possible afterwards.

Trachelectomy - Your surgeon will try to remove all of the cancer, but leave the internal opening of the cervix. This is then stitched up leaving a small opening for your period flow. The stitch will hopefully support a pregnancy until a baby can be born by Caesarean section.

Senior Cancer Information Nurse Stuart Danskin says, “Your doctor won’t be able to know 100% if he can do a trachelectomy until he’s operating. If the cancer is more advanced than predicted he may have to carry out a hysterectomy anyway.”

Emmeline Collin was 32 when she was diagnosed with cervical cancer. She’s 33 now and has a four year old daughter. She was told she had cancer and would likely have to have a hysterectomy. She was quickly referred to Addenbrookes hospital in Cambridge. She says, “I met my consultant, who was amazing and made me feel so much more confident about what was going to happen. He talked my husband and I through all of the options and explained the cancer fully. We decided that, as we had not yet completed our family and because I still had an early stage cancer, that I would have a new-ish operation called a radical trachelectomy.”

She says, “I felt like I’d been thrown a life-line, up until then my whole world had come crashing down , everything felt very negative as if the worst was going to happen.”

After a trachelectomy you have a slightly reduced risk of conceiving and there are concerns about premature delivery.

Cone Biopsy - This involves removing a cone-shaped piece of the cervix. This is mainly used as a treatment for abnormal cells but can sometimes be a treatment for very early cervical cancer. The area removed is where cervical cells are most likely to become abnormal.

LLETZ - (Large loop excision of the transformation zone) The transformation zone is the area of the cervix where abnormal cells are likely to develop. A LLETZ removes the abnormal cells in the area, usually under local anaesthetic.

Stuart Danskin takes calls from across the UK on the Macmillan cancer helpline. He says, “There’s a powerful instinct to have children and women will get a second opinion and look specifically for a surgeon who’ll attempt to perform a trachelectomy, for that reason.”