About 11,500 people in the United States are diagnosed with cervical cancer every year.
Cervical cancer happens often in the reproductive years. Almost 4 out of 10 people diagnosed with this disease are 45 and younger. The cervix plays an important role in pregnancy by helping keep the baby inside the uterus. If your cervix is removed or weakened during treatment for cervical cancer, it can make it difficult or impossible to conceive or carry a pregnancy to term. However, it is still possible for some people to conceive after having had cervical cancer.
We reached out to experts to find out more about getting pregnant when you have cervical cancer.
What are fertility-sparing treatments for cervical cancer?
There are a lot of considerations for healthcare providers (HCP) to take into account when treating cervical cancer while trying to protect someone's fertility, said Rachel Mandelbaum, M.D., a board certified reproductive endocrinologist at HRC Fertility. This includes the cancer stage, whether treatments such as radiation and chemotherapy are needed, and whether treatments will affect the ovaries and uterus.
Fertility-sparing surgeries treat cervical cancer but don’t affect your ability to get pregnant in the future. They're usually done when cervical cancer is in its early stages, when the cancer hasn't spread outside of the cervix, according to Ira Winer, M.D., a gynecologic oncologist at Barbara Ann Karmanos Cancer Institute.
Fertility-sparing surgeries include cone biopsy, also called cervical conization, and trachelectomy. Cone biopsies involve cutting a cone-shaped area of cancer cells out of the cervical tissue. Most people who have had this procedure and have no other fertility issues can go on to have a normal pregnancy and vaginal delivery.
A trachelectomy removes the entire cervix, the upper vagina and a small area of surrounding tissue. This procedure still allows for the possibility of becoming pregnant in the future. Because a trachelectomy means your HCP needs to place a stitch, called a cervical cerclage, on the lower part of the uterus, you’ll need to have a cesarean section if you get pregnant in the future.
Can you freeze your eggs for the future?
Yes. Even if you still have your uterus, radiation therapy to the pelvic area could damage the ovaries and affect your fertility. For some women, ovarian transposition, which moves the ovaries away from the field of radiation, may be an option. If not, egg freezing or embryo freezing can be done before treatment begins.
Egg freezing is a process where a reproductive endocrinologist, or a healthcare provider that specializes in fertility testing and treatments, surgically removes multiple eggs from the ovaries. Eggs can be frozen until you’re ready to use them. According to a 2022 study, the chance of having a baby after freezing your eggs is over 50% if you freeze them before age 38.
What are fertility treatment options after cervical cancer?
If you're unable to get pregnant on your own after cervical cancer, the good news is that there are plenty of options to have a baby with fertility treatments.
In vitro fertilization (IVF) is a type of fertility treatment that involves freezing your eggs. After eggs are retrieved, they can either be frozen or combined with sperm to fertilize into embryos. If you aren’t able to use your own eggs or your partner’s sperm, you also have the option of using an egg donor, sperm donor, or both. The embryos themselves can either be frozen for later use or transferred to the uterus.
When is a surrogate or gestational carrier needed?
If you have frozen eggs or embryos and your uterus has been removed, you have the option of using a gestational carrier. “If you’ve had extensive radiation, the uterine lining may also not grow and function normally to support a pregnancy,” said Mandelbaum. If your uterus can not support a pregnancy, a gestational carrier would be necessary.
A gestational carrier, or surrogate, is a person who carries and gives birth to your baby after undergoing IVF. This person doesn’t have a genetic link to the baby because they use your eggs or embryos. Some people may also use donor eggs or sperm.
“The steps to building a family may look different for many cancer survivors, even amongst those who may have had the same type of cancer,” Mandelbaum said. If you’re facing a cervical cancer diagnosis and want to get pregnant, talk with your HCP and care team about your options.
How do cancer and fertility treatments impact women of color?
Race, ethnicity and socioeconomic factors can negatively affect both cervical cancer and fertility treatment success.
Black women are twice as likely as white women to have difficulty getting pregnant regardless of whether they have cancer. They are also 50% less likely to seek help in getting pregnant.
Insurance status can further create racial disparities as one 2024 study showed. Medicaid doesn’t cover fertility treatments, and Black and Hispanic people are more likely to be covered by Medicaid than white people.
Another study showed Black women and women from other historically marginalized communities were more likely to be diagnosed with cervical cancer in later stages, when it’s harder to treat. Study participants who were uninsured or had Medicaid were less likely to have regular cervical cancer screenings.
This educational resource was created with support from Merck.
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