Introduction/Background Cervical cancer is the world’s fourth leading cause of cancer-related death in women. It is diagnosed in 38% of cases in patients up to 45 years old, making fertility-sparing treatments relevant. Regular requests include the absence of lymph node metastasis. Recently, an alternative for sparing the uterus and ovaries to pelvic radiotherapy effects was reported by Ribeiro et al. in 2017, the uterine transposition (UT). Although the oncologic and obstetrics outcomes should be proven for gynecological cancer management. This is the first report of spontaneous pregnancy and birth after uterine transposition for gynecological cancer.

Methodology We conducted this video-article showcasing the complete treatment journey of a 30-year-old patient diagnosed with stage IIIC1mi (FIGO 2018) adenocarcinoma cervical cancer submitted to Uterine Transposition. 14 months after chemoradiotherapy treatment and the uterine repositioning, she conceived spontaneously. A robotic double-cerclage was performed at 13 weeks after a normal morphological ultrasound and the pregnancy proceeded without complications.

Results The first birth worldwide following uterine transposition for cervical cancer occurred spontaneously with no reproductive assistance technique. The child showed normal neuro-psychomotor development at 6 months of age. The patient remains under oncologic follow-up with no evidence of disease for more than 24 months.

Conclusion Uterine transposition appears to promote fertility preservation and spontaneous pregnancy viability for whom require pelvic radiotherapy. The prevalence of cervical cancer in young women and delayed reproductive life highlight the importance of fertility-preserving techniques improvement. The LVLM in cervical cancer increases the staging and drives the radiotherapy treatment. In the absence of residual cervical neoplasia, the UT could be an option to fertility sparing. Better definition of many corner-stone steps are crucial to manage this strategy, and long-term follow-up is needed to evaluate the oncologic and reproductive outcomes associated with this procedure.