Reproductive outcomes after radical abdominal trachelectomy for cervical cancer

Objective: Some patients who have undergone radical trachelectomy require in vitro fertilization-embryo transfer. We examine the reproductive problems in patients with cervical cancer after radical abdominal trachelectomy. Methods: A retrospective single-center study of the fertility treatment for the cervical cancer patients who received radical abdominal trachelectomy was performed in 17 cases. One patient had stage IA1 disease with lymph-vascular involvement, 4 had stage IA2 disease, and 12 had stage IB1 disease. Histologically, there were 9 squamous cell carcinomas and 8 adenocarcinomas. Six patients received adjuvant chemotherapy. No deaths due to disease were observed. Results: The median age and length of follow-up were 36 years old and 71 months, respectively. Among the 12 patients desirous of pregnancy, 9 received in vitro fertilization (IVF), and 8 pregnancies were confirmed in 6 patients. Seven patients had cervical stenosis, and 4 of them needed transmyometrial embryo transfer. Two cases showed spontaneous abortion in the first trimester, and five resulted in births. The remaining case is in her 17th gestational week with no abnormal findings. One case had a fetomaternal transfusion syndrome, and another had partial placenta previa and preterm premature rupture of the membranes. Conclusions: In this small series of cases, the pregnancy rate after radical abdominal trachelectomy was 50%; most patients received transmyometrial embryo transfer was used for cervical stenosis.