In recognition of Cervical Cancer Awareness Month this September, it’s important to understand that a cervical cancer diagnosis doesn’t necessarily mean the end of your hopes of starting or expanding a family. With the proper care, early detection, and medical guidance, many young women can preserve their fertility or explore alternative paths to parenthood.
Understanding Cervical Cancer
Cervical cancer develops in the cells lining the cervix, the lower part of the uterus that connects to the vagina. It is most commonly caused by persistent infection with high-risk strains of the human papillomavirus (HPV), which is one of the most common sexually transmitted infections.
The good news is that cervical cancer is highly preventable and treatable when caught early. Pap smears and HPV testing, both widely available in South Africa through public clinics and private healthcare providers, play a crucial role in early detection of cervical cancer. Additionally, the HPV vaccine, available through school programmes and private providers, can dramatically reduce the risk of developing cervical cancer later in life.
While survival is the priority after diagnosis, for younger women, fertility preservation becomes an essential part of the conversation.
How Cervical Cancer Can Affect Fertility
The impact on fertility depends on the stage of the disease and the treatment required.
Surgery:
- Cone biopsy and trachelectomy are fertility-sparing surgeries often used in early-stage cervical cancer. These procedures remove cancerous tissue while preserving the uterus. While many women can go on to have healthy pregnancies, there is an increased risk of complications such as miscarriage, premature birth, or the need for caesarean delivery.
- In more advanced cases, a hysterectomy (removal of the uterus) may be necessary, which results in permanent infertility. If the ovaries are also removed, this leads to early menopause and the inability to produce eggs.
Radiation and Chemotherapy:
- Radiation therapy to the pelvic area can damage the uterus and ovaries, significantly lowering fertility potential, even when the uterus is preserved.
- Chemotherapy, depending on the drugs and dosage, can also reduce ovarian reserve, potentially leading to early menopause.
Because of these risks, doctors recommend discussing fertility preservation before starting treatment.
Fertility Preservation Options
South Africa has access to several internationally recognised fertility preservation methods, which are available at private fertility clinics and academic hospitals:
- Egg or embryo freezing (cryopreservation): Eggs are retrieved and frozen before treatment. In the case of embryo freezing, eggs are fertilised with sperm before storage.
- Ovarian tissue freezing: An option for urgent cases, where part of the ovary is removed and frozen for future re-implantation. This procedure is available, but may be limited to specific centres.
- Ovarian transposition (oophoropexy): A procedure that moves the ovaries away from the pelvic radiation field to reduce damage.
- Surrogacy and adoption: For those who cannot carry a pregnancy after treatment, legal surrogacy and child adoption are available, although both require specific legal and procedural steps.
Patients should be referred to a fertility specialist as early as possible, as decisions around preservation often need to be made quickly if cancer treatment must begin urgently.
Emotional Impact of Infertility Risk
Receiving a cancer diagnosis in your reproductive years is traumatic. Adding potential infertility into the mix can bring emotional distress, grief, and anxiety. Many women experience a deep sense of loss, even if they weren’t planning to have children immediately.
Support from counsellors, psychologists, and support groups can help individuals process their emotions and make informed decisions. Some women choose to prioritise fertility preservation, while others focus solely on recovery, opting to revisit the idea of children later. There is no one-size-fits-all answer, only what’s best for each individual’s health, values, and plans.
Cervical cancer may be a life-changing diagnosis, but it doesn’t mean giving up on the dream of having a family. With early detection, personalised treatment, and proper fertility counselling, many young women can still plan for motherhood in the future. Regular Pap smears, HPV testing, and routine check-ups are essential for protecting reproductive health.
Affinity Health supports women at every stage of their journey with access to 24/7 telehealth GP consultations, unlimited managed visits to Medical Society centres, specialist referrals, and diagnostic screenings, including blood tests and maternity scans.
