title: Fertility outcome after radical vaginal trachelectomy: a prospective study of 212 patients.
abstract: OBJECTIVE
  For treatment in patients with early-stage cervical cancer, radical vaginal trachelectomy (RVT) as a fertility-preserving surgery can be put on a par with radical hysterectomy as to oncologic safety. Our aim was to investigate the fertility concerns and outcome.
  
  
  METHODS
  Prospective collection of fertility data of patients treated with RVT. The data were collected on personal communication, by telephone, or e-mail correspondence. Descriptive statistical analysis was performed.
  
  
  RESULTS
  Between March 2005 and April 2010, 212 patients were followed up after RVT. Only 76 patients (35.9%) were seeking parenthood currently. Sixty pregnancies occurred in 50 women. Five patients (8.3%) had first-trimester miscarriage, 3 had second-trimester miscarriage (5.0%), 2 patients decided for pregnancy termination (3.3%), and 1 patient (1.7%) had an ectopic pregnancy. Three women (5.0%) delivered prematurely before 28th weeks of gestation, 15 (25.0%) delivered between 28 and 36 weeks, and 27 women (45.0%) reached full term. Four pregnancies are ongoing.
  
  
  CONCLUSIONS
  Preservation of childbearing function is a great advantage for patients with early-stage cervical cancer. Many patients do not seek parenthood immediately. We see no impairment of fertility and have solid data on pregnancy outcome. Premature labor is the main problem in pregnancy after RVT.
authors.affiliation: Department of Gynecology, Charité University Medicine, Berlin, Germany.
authors.forename: Dorothee
authors.initials: D
authors.lastname: Speiser
authors.forename: Mandy
authors.initials: M
authors.lastname: Mangler
authors.forename: Christhardt
authors.initials: C
authors.lastname: Köhler
authors.forename: Kati
authors.initials: K
authors.lastname: Hasenbein
authors.forename: Hermann
authors.initials: H
authors.lastname: Hertel
authors.forename: Vito
authors.initials: V
authors.lastname: Chiantera
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Gottschalk
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Lanowska
mesh_terms: D000328:Adult; D005260:Female; D059247:Fertility Preservation / Q000379:methods*; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D055815:Young Adult