Trachelectomy

For more invasive cancer, you may be able to have a trachelectomy, as long as the cancer is not really deep or metastasized. This procedure is removal of the cervix, essentially.  It's an option for women with 1a or 1b diagnoses.

Some women have this after a LEEP or a cone biopsy diagnoses that the cancer is bigger than 2 cm.

Now, since the cervix is really a connection from the vagina to the uterus, not a separate organ, how is this possible? The surgeon removes the cervical tissue down to the wall and also removes about 2 cm of the upper vagina, and then reattaches the uterus to the vagina. Then, because it's just open from the vagina directly into the uterus, the surgeon puts in a special cerclage called a Shirodkar cerclage to close (or nearly close) the opening to the uterus. That's essential to carry a baby.

Not many surgeons know how to do this procedure, so if you have to go that route, you will probably have to travel somewhere to have it done unless you are lucky enough to live near one of the few specialists. Check out the list of doctors on this site. And you will have to spend a couple days in the hospital. They also recommend that you wait 6 months to a year before trying to conceive.  It's a major surgery, and there's a lot to heal.

Conceiving and pregnancy after trachelectomy

The great news is that most women are able to conceive naturally!  Some may need the help of a fertility doctor for unrelated reasons like endometriosis or age, but since the ovaries and uterus are still perfectly functional, natural pregnancy is generally possible.  Of course, without a normal cervix, you would lack cervical mucus, but at the same time, you have a shorter route into the uterus for the sperm to travel.  

When you do get pregnant, to deliver the baby, you'll have to have a c-section because the Shirodkar cerclage is permanent. It's like they rebuilt a cervix surgically, but it doesn't stretch.  At least you can still have a baby!  And the pregnancy rates are really good post-trachelectomy. Getting pregnant is really no different, but pregnancy certainly would be.  You would have to see a pregnancy specialist throughout the pregnancy.  See what Dr. Pedro Ramirez from MD Anderson Cancer Center had to say about the procedure.