Fertility after cervical cancer

Losing your fertility after cervical cancer is a fear most women have when faced with surgery like LEEP or cone biopsy. The informed consent that you sign before surgery makes it sound pretty grim. It is scary reading, but they do have to tell you the worst-case scenario.

The good news is that having HPV does not affect your fertility or whether or not you can go through infertility procedures, if you need help getting pregnant. I think most people know that untreated chlamydia and other sexually-transmitted diseases can cause infertility because they scar the fallopian tubes, but HPV is not like that. The problems with HPV and fertility have to do with the surgery you have to remove abnormal cervical tissue.

The key problems with conception post-surgery are:

All of these problems can be solved. There is also a possibility of endometriosis after surgery, but that's hard to blame completely on the surgery.  It's a chicken or the egg situation.

Usually after surgery, whether you have a LEEP, a cone biopsy, or a trachelectomy, the doctors tell you to wait at least 6 months before you try to conceive. The cervix has to heal, and they also will want you to come back for followup Pap smears to make sure that you're back to normal.  When you can have intercourse again depends on which surgery you had.

Some women still have dysplasia (abnormal Pap smear), and if HPV is still positive, then doctors get nervous. You may have to go every 3 months for followup at first.

Generally, gynecologists advise women under 35 years old to try for a year to conceive before seeking help, and women over 35 years old should only try for 6 months.

If you have had cervical surgeries, it's not a bad idea to go see a reproductive endocrinologist or RE before you try to conceive. Why spend 6 months to a year trying to conceive only to find out later that your tubes were blocked? It costs money to go through diagnostic procedures to find out nothing is wrong, but wasting time is worse.

While surgery on your cervix is not really helpful for future conception, it doesn't have to be the end. It may just add a few detours. And yet you can still have a normal pregnancy and labor and delivery.