Introduction/Background Fertility-sparing surgery (FSS) aims to achieve oncological outcomes non-inferior to radical treatment while preserving fertility and optimizing reproductive results. We assessed in vitro fertilization (IVF) outcomes in early-stage cervical cancer survivors following FSS, comparing radical and non-radical approaches.

Methodology This retrospective analysis used data from Hungary's National Health Insurance Fund (2006–2022) involving patients who underwent IVF treatments at ten Hungarian fertility clinics following FSS for early-stage cervical cancer. Patients were classified into radical and non-radical surgical groups. Uterine arteries were spared in non-radical procedures.

Results The study analyzed data from 122 IVF treatment cycles involving 36 patients. Eleven babies were born, with a significantly higher live birth rate in the non-radical group (83%) compared to the radical group (28%). The implantation rate and the cumulative live birth rate per oocyte retrieval were also significantly higher in the non-radical group (37% and 55% vs. 8% and 6%, respectively).

Conclusion This is the largest study evaluating IVF outcomes in young cervical cancer survivors who had undergone FSS. Less radical procedures, preserving uterine arteries are associated with better IVF outcomes. These findings emphasize the importance of considering oncological safety and reproductive outcomes together when choosing FSS for early-stage cervical cancer patients, highlighting the reproductive benefit of performing less radical surgery.

Disclosures The authors report no conflict of interest.