Fertility options for patients with stages IA2 and IB cervical cancer: presentation of two cases and discussion of technical and ethical issues.

Abstract

Ten percent to 15% of women diagnosed with cervical cancer are in their childbearing years. Traditional therapy for stage IA2 and IB lesions, radical hysterectomy, negates future fertility potential. Assisted reproductive technology might offer these women fertility options. Two cases of young nulliparous women with stage IA2 cervical cancer, who underwent ovarian stimulation and oocyte retrieval followed by radical hysterectomy, were presented to illustrate the technical difficulties of oocyte stimulation and retrieval in the setting of cervical carcinoma. Many issues should be considered when counseling a woman with early-stage cervical cancer about future fertility. These include ethical issues of embryo freezing and gestational surrogacy and practical issues of ovarian preservation and transposition. No current guidelines exist to identify appropriate candidates for assisted reproductive technology in this setting.