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Cervical Health Awareness and Your Fertility
January 16, 2013
When it comes to reproductive health, you may not think about your cervix as often as you should. However, approximately 12,000 new cases of cervical cancer are diagnosed in the United States each year and can lead to cervical infertility, cervical incompetence during pregnancy, or pregnancy loss.
January is Cervical Health Awareness Month, and you owe it to yourself to understand how cervical cancer impacts your fertility.
Fertility Treatment and Cervical Cancer
Before you begin treatment at a fertility clinic, your fertility doctor will review your OB-GYN records to be sure your most recent Pap Smear results are not indicative of a cancerous biopsy. Samuel Brown, M.D., of Brown Fertility Associates in Jacksonville, Florida says: “If a patient has a diagnosis of cancer, we can’t use fertility drugs, so we have to make sure they are clear from a Pap Smear perspective.”
For those who have a history of abnormal Pap Smears and cancer cell removal, there are options for successfully conceiving and maintaining a healthy pregnancy. Women who have had a LEEP procedure to remove abnormal cells will be treated with heightened awareness to decrease the risk of cervical incompetence. These patients would be strongly encouraged to do a Single Embryo Transfer (SET), and may be candidates for a cerclage (stitch placed in the cervix) to reduce the risk of cervical incompetence and pregnancy loss.
Women who have undergone cryotherapy for freezing abnormal cervical cells may experience a decrease in cervical mucus which can inhibit sperm from fertilizing an egg. In this instance, intrauterine insemination (IUI) will bypass the cervix and any associated cervical infertility.
Fertility Preservation Before Cervical Cancer Treatment
But what happens if you are diagnosed with cervical cancer in the midst of fertility treatment cycles?
Dr. Brown assures patients that fertility doctors can move quickly to preserve a patient's fertility before undergoing harsh chemotherapy or hysterectomy. “We treat the cancer first and postpone [fertility] treatment. If a patient has cervical cancer that requires a hysterectomy, we can freeze their eggs [or embryos] and arrange for them to use a gestational carrier. The ovaries can be moved up to get them out of the line of radiation, or Lupron can be used to suppress ovarian function pre-chemotherapy. Alternatively, a trachelectomy, which removes the cervix and requires a permanent cerclage during pregnancy and thereafter, would allow the patient to get pregnant and carry their own embryos, though a caesarian section is needed at birth”, he states.
Within a 5 week period, fertility doctors can rapidly stimulate the ovaries for follicle growth, retrieve mature eggs, and freeze eggs or embryos to provide patients a shot at parenthood after cancer treatment.
How to Screen for Cervical Cancer During Fertility Treatment
Most importantly, women must be proactive about screening for cervical cancer and treating it in a timely manner. Annual Pap Smears performed by your regular OB-GYN, Human Papillomavirus (HPV) screenings, and knowing the signs of cervical cancer are the keys to monitoring cervical health.
Dr. Brown leaves patients with the reassurance that fertility drugs do not increase the risk of cervical cancer and have been scientifically shown to improve receptivity to chemotherapy in patients who underwent IVF prior to radiation therapy. “Regarding cervical cancer…ten years ago we had no options, but today we have options,” he reminds us.