Can I still have children if I have cervical cancer?

With the popularization of cervical cancer screening methods, more and more young cervical cancer patients are detected in the early stages. Moreover, with the delay in childbearing age and the opening of the second child policy, many young cervical cancer patients still have the desire to have children when they are diagnosed. Therefore, in addition to considering the patient's prognosis, gynecological oncologists must also pay attention to the patient's desire to become a mother.

So can you still have a baby if you have cervical cancer?

The answer is yes, but the scope of application must be strictly controlled. So which patients can undergo cervical cancer fertility preservation surgery? The first definition that must be established is that the purpose of fertility-preserving surgery for cervical cancer is to preserve fertility as much as possible without affecting the patient's prognosis. Therefore, according to the manual, fertility preservation treatment is limited to young patients in stage IA, IB1-IB2 (strongly recommended for exophytic tumors with a maximum tumor diameter of ≤2cm) who have a clear desire to preserve fertility. However, some special pathological types of cervical cancer, such as small cell neuroendocrine carcinoma, intestinal adenocarcinoma and minimally invasive adenocarcinoma, are not suitable for fertility preservation surgery due to their high degree of malignancy.

So what are the methods of surgical treatment for cervical cancer to preserve fertility?

Includes cervical conization, simple cervical excision and enriched cervical excision.

Regardless of which method is used, although the fertility function is preserved, there may still be some problems with pregnancy after surgery, including: (1) The cervical canal stenosis is more common, or even completely blocked: The cervical canal stenosis after surgery can prevent male sperm from entering the uterus, resulting in obstructed menstrual discharge and affecting subsequent pregnancy. (2) Vaginal reduction and narrowing: Patients may experience pain during sexual intercourse, which affects the quality of life of the couple and may even cause them to fear sexual intercourse. (3) Impact on sperm capacitation: Surgical removal of part of the cervical tissue reduces the metabolism of cervical mucus, thereby affecting the movement and capacitation of male sperm. (4) Intrauterine infection and placental abruption: Because most of the cervix has been removed, the cervix's natural barrier function against retrograde infection is weakened, and the chance of retrograde infection continues to increase, which can easily lead to intrauterine infection and placental abruption. (5) Pelvic adhesions and their influence on the uterine wall affect subsequent pregnancy.

Regarding the time interval for pregnancy after surgery, it is recommended to be at least half a year. The actual time interval should be determined based on the patient's postoperative recovery condition and pregnancy requirements. For patients who fail to conceive through artificial insemination after surgery, it is recommended to use assisted reproductive technology as soon as possible, and it is recommended to perform cesarean section to deliver the baby.

In general, cervical cancer surgery that preserves fertility provides young cervical cancer patients with the possibility of pregnancy, but it is necessary to conduct a careful evaluation before the operation, strictly grasp the indications, formulate a surgical plan based on the patient's condition and pregnancy requirements, and closely follow up after the operation to detect changes in the condition.