Introduction Composing approaches to early cervical cancer (CC ≥2 cm in tumor size) in fertile years implicates around the preservation of the reproductive function; on whether the following intervention (i.e., operative procedures with/without neoadjuvant chemotherapy (NACT)) offer acceptable child-bearing potential within an estimable risk of cancer recurrence? This study aims to measure the obstetric and oncologic outcomes among woman with early CC ≥2 cm treated by fertility-sparing management.

Methods This study is in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) to review cohorts from the last decade, focused on fertility-sparing intervention among woman with CC ≥2 cm. The obstetric outcome is consisted by pregnancy rate (PR), living-birth rate (LBR), and pre-term rate (PtR); supported by the recurrence rate (RR) and moderated by NACT status. The statistical analyses were performed with random-effect model (REM) in Comprehensive Meta Analysis (CMA) version 3.0.

Results We included 16 studies encompassed by 499 individuals to the final analysis. The estimated overall obstetrical outcomes were 32.4%, 58.5%, and 37.1%, respectively. Prior NACT administration proved to increase the outcomes e.g., PR (47.6% vs. 22.5%) and LBR (73.1% vs. 35.7%); though the findings were not observed on PtR (37.1% vs. 33.3%). Interestingly, we also found that the RR was higher among NACT+ populations (12.1%) compared to its control (5.1%).

Conclusion/Implications Fertility-sparing treatment may substantially affect the obstetric outcomes among women with CC ≥2 cm which can be improved by NACT administration, though our study revealed a possibility of worse oncologic outcomes among NACT-receiving individuals.