Cervical cancer is the fourth most common cancer in women worldwide. Despite successful screening programs in high-resource countries, the impact of cervical cancer remains significant, particularly in women aged 35 to 49, with 40% of cases diagnosed during reproductive years [1].

Conventional treatment for early-stage cervical cancer involves radical hysterectomy with pelvic lymphadenectomy, which results in immediate fertility loss [2]. Fertility-sparing surgery (FSS) aims to achieve oncological outcomes that are non-inferior to radical hysterectomy while optimizing reproductive outcomes, including fertility preservation and minimizing the risk of preterm birth [2].

In a radical trachelectomy, the cervix, vaginal vault, and supporting ligaments are removed, leaving the uterine corpus intact [3]. Radical trachelectomy is associated with excellent oncological outcomes and a low recurrence rate. However, it is also associated with significant patient morbidity, including adverse reproductive outcomes such as reduced fertility [4] and increased rates of first- and second-trimester miscarriage and preterm birth [5].

There is a growing body of evidence supporting the safety of non-radical surgery in patients with early-stage, low-risk cervical cancer. The recently published prospective ConCerv trial demonstrated that conservative surgery, like cervical conization can be a viable option for this patient population, maintaining optimal recurrence and survival rates without compromise [6].The randomized SHAPE trial further validated these findings. It suggests that selected low-risk cervical cancer patients can expect fewer side effects and a potentially better quality of life when treated with simple hysterectomy instead of radical hysterectomy with non-inferior oncological outcomes [7].

Studies evaluating fertility outcomes in patients following FSS have reported variable success rates. Recent data from a systematic review showed a moderate clinical pregnancy rate (53.2%) among patients attempting to conceive after fertility-sparing surgery (FSS) [8]. The mode of conception was predominantly spontaneous (79%), with a smaller proportion using assisted reproductive technology (ART). The same study reported a higher live birth rate in patients who underwent simple trachelectomy or conization compared to those who underwent radical trachelectomy [8]. Another review suggests that infertility treatment is required for the majority of pregnancies following radical abdominal trachelectomy [9].

Although infertility treatment is not infrequent in this population, there is limited knowledge about the effectiveness of ART treatment in women undergoing FSS. Obtaining comprehensive information on in vitro fertilization (IVF) outcomes is essential to provide patients with accurate data for informed decision-making regarding their post-cancer pregnancy options. The aim of our study was to assess IVF outcomes in patients with early-stage cervical cancer who underwent fertility-sparing procedure and to compare the results between radical and non-radical procedures.