Introduction/Background The standard procedure in cervical cancer is radical hysterectomy (RH) and pelvic lymphadenectomy (PLND). Because of the increasing age of women at childbirth, fertility becomes a major challenge. We present pregnancy results after less radical fertility-sparing surgery in women with IA1, LVSI positive, IA2 and IB1 (<2 cm, infiltration less than half of stromal invasions.

Methodology Laparoscopic sentinel lymph node mapping (SLNM) with frozen section (FS) followed by PLND and ‘selective parametrectomy’ (removal of afferent lymphatic channels from the paracervix) in case of a negative result was performed in all women. If lymph nodes verified negative by definitive histopathology, patients were treated by simple trachelectomy (IB1) or large cone (IA1/IA2) biopsy 1 week after primary surgery.

Results From 1999 to 2018, 91 women were enrolled in the study (median age 29.1 years, range 21–40). In 76(83.5%) fertility was spared, 13 (17.1%) of them don’t want to be pregnant and 63 (82.9%) wished pregnancy. 54 from 63 women conceived (pregnancy rate 85.7%) and 48 from 63 women delivered 58 babies (delivery rate 76.2%). 39 women delivered in term (67.2%), 13 women between 32 and 36+6 weeks of pregnancy, 3 between 28 and 31+6 weeks and 3 between 24 and 27+6 weeks. Only one woman still plan pregnancy. One woman is currently pregnant.

Conclusion Goal of fertility-sparing surgery is not only good oncological results, but also good pregnancy results. Pregnancy results after less radical fertility-sparing procedure seems to be very good (pregnancy rate 82.9% and delivery rate 76.2%). This work is supported by Cooperatio program 207035, Maternal and Childhood Care, 3rd Faculty Medicine, Charles University.