Cervical Cancer Treatments and Fertility: What Women Need to Know

In Malaysia, there is a significant concern for the health of women aged 15 years and above, totaling around 12.8 million, who are at risk of developing cervical cancer. Shockingly, each passing year delivers distressing news to approximately 1740 women who receive a cervical cancer diagnosis. Tragically, this disease claims the lives of 991 women annually¹.

However, amidst these distressing numbers, there's a silver lining. Cervical cancer can indeed be treated effectively, particularly when detected at an early stage. Nonetheless, concerns often arise among women of reproductive age – concerns tied to the potential impact of cancer treatment on their ability to bear children.

For these women, a pressing question emerges: Could fertility-sparing treatments offer a ray of hope?

Fertility-Sparing Options

Conization

Conization, also known as cone biopsy, stands as a surgical procedure targeting the removal of cancerous tissue along with a portion of healthy tissue surrounding the cervix.

This procedure offers women the chance to conceive in the future. However, it's worth noting that it may also raise the risk of miscarriage or infertility due to cervical scarring. It is generally recommended that women wait for a span of 6 to 12 months before attempting conception post the conization procedure².

Trachelectomy

Recommended for women with small tumors and early-stage cervical cancer who wish to maintain fertility, trachelectomy without the removal of the cervix.

After the procedure, a waiting period of 6 to 12 months is often recommended before attempting pregnancy. It's important to note that pregnancy post trachelectomy is considered high-risk, possibly necessitating a C-section delivery³.

Egg or Embryo Cryopreservation

​For women facing the possibility of chemotherapy, radiation, or even a hysterectomy, freezing eggs or embryos can present a viable solution.

Cervical cancer treatments might impair the uterus or eggs, rendering conception difficult or even unattainable. Through the preservation of eggs or embryos, women can explore in-vitro fertilisation (IVF) or other assisted reproductive techniques³.

In Malaysia, this option is presently accessible to married couples if they are Muslim and can be financially demanding, ranging from RM15,000 to RM17,000⁴.

Ovarian Transposition

Radiotherapy used to treat cervical cancer can adversely affect ovarian function, impacting fertility. Ovarian transposition involves relocating the ovaries out of the radiation field before the commencement of radiation therapy. This procedure aims to preserve fertility and enhance the likelihood of pregnancy following treatment³.

Dealing with Infertility

Infertility can be emotionally taxing and have far-reaching effects on relationships, careers, and mental well-being. Cervical cancer treatments, such as hysterectomy or radiotherapy, can lead to infertility.

For instance, a hysterectomy involves the removal of the uterus, causing menstrual cycles to cease and potentially impacting pregnancy possibilities. Women considering their future family plans should prioritise discussing fertility preservation options with their healthcare provider before embarking on treatment.

Prioritise Communication

It's paramount to engage in an open and candid dialogue with your healthcare provider concerning concerns about fertility preservation prior to commencing cervical cancer treatment. The landscape offers a range of options, and the most suitable approach for one individual might not be equally fitting for another.

Don't shy away from asking questions or advocating for yourself. With DoctorOnCall, you can access unparalleled care and unwavering support by your side. Remember, taking proactive steps can significantly contribute to your peace of mind and confidence throughout this challenging journey.