Volume 30, Issue 172, June 2026

Fertility-Sparing Treatment in Early- Stage Cervical Cancer: Oncologic Safety and Pregnancy Outcomes

Wiktoria Wiśniewska^1♦, Damian Zienkiewicz², Gabriela Makulec³, Karolina Domosud³, Weronika Walendziak⁴, Natalia Mordal¹, Kacper Ściebura³, Magdalena Ostaszewska⁴, Milena Majchrzyk⁴, Anna Malczyk⁵, Laura Mikuła⁶

¹Mazovian Bródno Hospital, Kondratowicza 8, 03-242 Warsaw, Poland
²Praga Hospital of the Transfiguration, Solidarności 67, 03-401 Warsaw, Poland
³Military Institute of Medicine - National Research Institute, Szaserów 128, 04-141 Warsaw, Poland
⁴The National Medical Institute of the Ministry of the Interior and Administration, 02-507 Warsaw, Poland
⁵Międzyleski Specialist Hospital, Bursztynowa 2, 04-749 Warsaw, Poland
⁶Czerniakowski Hospital, Stępińska 19/25, 00-739 Warsaw, Poland

^♦Corresponding author
Wiktoria Wiśniewska, Mazovian Bródno Hospital, Kondratowicza 8, 03-242 Warsaw, Poland

ABSTRACT

Cervical cancer is one of the most common cancers in women of reproductive age. As a result, fertility preservation is now considered an integral component of standard oncology care. Fertility-sparing therapy (FST) includes early-stage cervical conization and more complex surgical procedures, for example, radical trachelectomy with pelvic lymph node evaluation. For patients with larger tumors, neoadjuvant chemotherapy (NACT) is being investigated as an experimental option before fertility-sparing surgery. This review summarizes current evidence on the safety and reproductive outcomes associated with FST in patients with early-stage cervical cancer. We searched PubMed/MEDLINE and Google Scholar for systematic reviews, cohort studies, retrospective analyses, and clinical guidelines. Studies published within the last 10 years were prioritized. The review examines patient selection, key tumor characteristics, cancer treatment outcomes, and the possibility of having children. Current evidence shows that patients with FIGO IA1-IB1 disease, tumors 2 cm or smaller, favorable pathology, and no lymph node involvement can have cancer outcomes with FST like those after radical hysterectomy. Women who undergo FST generally achieve encouraging reproductive results, with pregnancy rates surpassing 50% in most reported series. That said, more extensive surgical interventions carry a meaningful increase in the risk of both miscarriage and premature delivery. Preliminary findings on NACT followed by fertility-sparing surgery in tumors ranging from 2 to 4 cm show promise, though larger prospective trials are still needed to better define which patients benefit most.

Keywords: Cervical cancer; Fertility preservation; Radical trachelectomy; Oncologic safety; Pregnancy outcomes

Medical Science, 2026, 30, e116ms3922

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DOI: https://doi.org/10.54905/disssi.v30i172.e116ms3922

Published: 30 June 2026