Carcinoma of the cervix, like all other carcinomas, is classified into different stages, depending on its size and the borderline areas to which it extends, as well as the presence or absence of metastases.
This classification will determine the treatment to be performed. It is this treatment, together with the prognosis of the cervical cancer itself, which will determine the patient's reproductive future.
On the one hand, small carcinomas, which can be treated with conization or surgery limited to the cervix such as trachelectomy, in which the anatomical integrity of the uterine body is maintained, the woman can conceive. However, intervention on the cervix may cause future obstetric difficulties such as incompetent cervix during gestation or rigid cervix at the time of delivery.
On the other hand, in carcinomas in which the extension of the cervical cancer requires hysterectomy (removal of the uterus), it will no longer be possible to gestate.
In addition to the surgical treatment necessary for the treatment of the carcinoma, it is necessary to take into account, for the reproductive prognosis of the woman, the adjuvant treatments that must be carried out. Thus, if the patient is going to undergo chemotherapy or pelvic radiotherapy or brachytherapy (endocavitary radiotherapy), it is necessary to evaluate the possibility that these therapies destroy the follicular endowment of the woman and, therefore, determine the subsequent impossibility of obtaining a gestation with her own oocytes despite the fact that the treatment proposed preserves the uterus. It is therefore essential, in all cases in which a patient is going to be treated with radiotherapy or chemotherapy, to explore whether her genetic desire has been fulfilled.
So if this is not the case, and the uterus is going to be preserved, the patient should be offered the possibility of vitrification of oocytes so that in the future, when the cancer is only a bad memory, the woman can fulfill her desire to be a mother.
