Cervical Cancer and Pregnancy: The Latest Research

If you’ve been diagnosed with cervical cancer, you might have concerns about how it could affect your ability to become pregnant. Recent research shows that doctors don't always share all the information people need about treatment options and fertility. While some cervical cancer treatment can harm fertility, there are options to help protect your ability to become pregnant after treatment.

Women may not be aware of their options

A new study published in JAMA Network Open looked at whether people with cancer received information about options to help them have children. The study found that only half of those between the ages of 18 and 49 reported that they were informed about what they could do to preserve their fertility before beginning treatment. In women, “fertility” means the ability to become pregnant and carry the baby through pregnancy.

“While we would like to think that every doctor is going to bring up fertility preservation, we know that’s not always being done. There’s a number of studies that tell us that. And, so, I think that is where patients can really advocate for themselves and specifically ask the question of, what are the chances that this treatment or treatments will allow me to successfully carry a pregnancy afterward?” said Eleonora Teplinsky, MD, an American Society of Clinical Oncology (ASCO) expert and head of breast and gynecologic medical oncology at Valley-Mount Sinai Comprehensive Cancer Care.

How cervical cancer treatments can impact fertility

Several cervical cancer treatments can affect fertility. These include:

• Surgery. Different types of surgery are used to treat cervical cancer. For example, the uterus and cervix may be removed. The cervix is the lower part of the uterus and connects the body of the uterus to the vagina. The uterus is where a fetus, or unborn child, lives and grows. When the cervix and uterus are removed, carrying a pregnancy is not possible.
• Radiation therapy. Some people with cervical cancer might receive radiation therapy to their pelvic area where the cancer was found. This could damage the ovaries and their ability to function, which could affect fertility.
• Chemotherapy. Some chemotherapy (chemo) drugs used to treat cervical cancer cause damage to reproductive organs. This can lead to early menopause, which can affect fertility. The risk for this is particularly high for people receiving high doses of a drug or a combination of drugs.

Pregnancy after cervical cancer is possible

Many people are still able to become pregnant and carry a pregnancy after cervical cancer. For example, a recent study found that nearly half of people who received fertility-sparing surgery and tried to conceive after treatment were able to have a successful pregnancy.

“I really would like to stress that a diagnosis of cervical cancer does not mean that you will not be able to have a child after,” said Dr. Teplinsky. “But it really does depend on the stage, the extent of the disease, and the treatment planned.”

Options for fertility preservation

There are several fertility preservation options for people with cervical cancer. For example, some people might be able to receive a fertility-sparing surgery called a trachelectomy. During this type of surgery, the cervix is removed. However, the uterus remains. This can preserve the ability to carry a pregnancy.

There are other preservation options for people who might not be able to receive fertility-sparing surgery. These include egg freezing and embryo freezing. Most times, people can safely have these procedures done before cancer treatment begins.

For people receiving radiation therapy, ovarian transposition can also be an option. During this procedure, the ovaries are moved away from the radiation field to prevent damage.

Discuss side effects before treatment begins

If you hope to have children after cervical cancer, talk with your doctor before treatment begins. “Have that conversation early on to think about ways you can preserve fertility, whether through surgery, egg or embryo freezing, or ovarian transposition,” said Dr. Teplinsky. “And even if those are not options for you, there are still ways to become a parent after a cancer diagnosis.”

Even though your doctor might not discuss how cervical cancer can affect fertility with you, this information can be key to determining your treatment plan. Bring the subject up with your doctor to be sure get answers to any and all questions you might have.

“Often, unfortunately, the patient may have to bring it up and say, what are the odds of this treatment causing infertility?” said Dr. Teplinsky. “And if there is a chance that I may become infertile, are there steps that we can take now to improve my fertility?”

Questions to ask about pregnancy and cervical cancer treatment

Some questions to ask your doctor include:

• What are my treatment options?
• How might each treatment option affect my ability to become pregnant?
• What are the chances I will be able to become pregnant after treatment?
• What can I do to preserve my fertility before treatment begins?
• Can I safely wait to begin treatment to undergo egg or embryo freezing?
• If I am receiving radiation therapy, is ovarian transposition an option for me?
• Can you refer me to a fertility specialist?

Learn more

Learn more about cervical cancer and fertility from the American Cancer Society:

• Female reproductive anatomy
• Cervical cancer risk, prevention, screening, diagnosis, and treatment
• Fertility and sexual side effects of cancer and Its treatment
• Preserving fertility in young people with cancer

Dr. Teplinsky is a member of ASCO’s Patient Information Editorial Board.