To date, cervical carcinoma is the second most common cancer in women worldwide, and one in two women is diagnosed under the age of 35. Due to good cancer screening programs, one third of all cervical cancers in Europe are now diagnosed in early tumour stages. Depending on the type (squamous or adeno­car­cinoma), stage and lymph node involve­ment the prognosis is assessed individually.

Surgical treatment of a precan­cer­ous stage does not sig­ni­fic­antly limit fertility and newer surgical tech­niques also reduce the negative impact on the function of cervical closure in sub­sequent pregnancies.

Nev­er­the­less, the treatment of a cervical carcinoma can have a quite sig­ni­fic­ant impact on fertility in many ways. In early stages and low tumour extension surgery is primarily a curative therapy with pre­ser­va­tion of the ovaries (whenever possible). In higher stages, the uterus has to be removed and a pregnancy would thus no longer be possible.

In the case of a combined radiochemo­ther­apy of the small pelvis, the ovaries can be moved out of the radiation field (trans­lo­ca­tion) and at the same time ovarian tissue could be removed for freezing (cryo­p­reser­va­tion). The damaging effect of radio­ther­apy depends on the overall dose at the ovaries, and the age of the woman. Very high doses can also cause massive uterine tissue damage pre­vent­ing a sub­sequent pregnancy. Potential risks of the trans­lo­ca­tion of the ovaries, such as meta­stas­is to the ovaries and a possible restric­ted blood supply must be discussed in advance with all related disciplines.

One way to facil­it­ate the patient’s decision after the con­sulta­tion regarding fertility-pre­serving measures is the  “Decision Aid” linked here.

This digital decision aid has been developed by psy­cho­lo­gists, psy­cho­ther­ap­ists and repro­duct­ive phys­i­cians and might help in an indi­vidu­al situation.

Detailed inform­a­tion and a bib­li­o­graphy can be found in the Fer­ti­PRO­TEKT booklet “Indika­tion und Durch­führung fer­til­ität­s­pro­tekt­iver Maßnahmen bei onko­lo­gis­chen und nicht-onko­lo­gis­chen Erkrankun­gen”, 2nd revised edition 2020, which was written by members of the Fer­ti­PRO­TEKT Netzwerk e.V. and is available free of charge (in German).

(Chap. 2.5)

An english version can be bought: Fertility Pre­ser­va­tion in Onco­lo­gic­al and Non-Onco­lo­gic­al Diseases a practical guide by Michael von Wolff & Frank Nawroth ISBN 978–3‑030–47567‑3 from
Part II.V page 77ff