Fertility sparing procedures specific to certain cancers
As well as the fertility preservation options outlined on the previous pages, if you have been diagnosed with cervical cancer, or are being treated with radiotherapy to the pelvis, there may be specific fertility preservation treatments available to you. These are provided by your cancer care team and may also help preserve your fertility. The cancer care team talk with women about having these fertility sparing procedures as part of their cancer treatment.
Trachelectomy is a surgical procedure to remove cancer from the cervix. The cervix, upper part of the vagina and lymph glands in the pelvis are taken out. The womb is left in place. This may be an option if you have been diagnosed with early stage cervical cancer. The side effects can include bleeding and infection, blood clots in the veins (thrombosis). Surgical side effects can be a cut in your bowel or bladder causing further bladder problems, and problems with menstruation. This is a day surgery procedure, and does not cause any delays to cancer treatment. A trachelectomy gives a woman with early cancer of the cervix the chance of having a baby after cancer treatment. There is a chance of miscarriage and premature birth for women who become pregnant after the surgery. The baby will need to be delivered by Caesarean section (C-section). Studies have shown that a trachelectomy does not affect the chance of the cancer coming back.
Ovarian transposition is a surgical procedure that moves the ovaries away from the field of the radiotherapy treatment. This may be an option if you are receiving radiotherapy treatment to the pelvis. The side effects can include injury to internal organs. This is a day surgery procedure, and does not cause any delays to cancer treatment. The chance that ovarian transposition will help a woman to have a child after cancer treatment is not known. Studies have shown that ovarian transposition does not affect the chance of the cancer coming back. It does not protect the ovaries against the effects of chemotherapy.
Ovarian shielding works by protecting the ovaries during radiotherapy treatment. This may be an option if you are receiving radiotherapy to the pelvis. During your radiation treatment, a protective cover is placed on the outside of the body, over the area of the ovaries. You will be able to go home straight after the radiation treatment.
The shielding does not delay cancer treatment. Although this may be offered to you, the data suggests that ovarian shielding gives poor protection of the ovaries during radiotherapy treatment. The chances of having a child after cancer treatment is not known. It is not yet known whether ovarian shielding affects the chances of cancers growing or coming back. It does not protect the ovaries against the effects of chemotherapy.
You may find it useful to write down what you like about this option and what worries you about this option.
These notes may help you talk about whether or not this option is best for you with your cancer care team and fertility care team, partner, family and friends.