Reducing radicality in fertility-sparing surgery is associated with improved in vitro fertilization outcome in early-stage cervical cancer: A national retrospective study

Objective. Fertility-sparing surgery (FSS) aims to achieve oncological outcomes that are non-inferior to radical treatment while preserving fertility and optimizing reproductive results. This study assesses in vitro fertilization (IVF) outcomes in early-stage cervical cancer survivors following FSS, comparing radical and non -radical approaches. Methods. This retrospective analysis used data from Hungary's National Health Insurance Fund (2004 -2022) on patients who underwent IVF treatment following FSS for early-stage cervical cancer at ten Hungarian fertility clinics. Patients were classi fied into radical and non -radical surgical groups, with the uterine arteries being spared in the non -radical procedures. RStudio (R software version: 4.2.2) was used for statistical analysis. Student's t -test was used to compare group means, and Fisher's exact test was applied to assess independence and distributions between categorical variables, and to estimate odds. Results. The study analyzed data from 122 IVF treatment cycles involving 36 patients. The non -radical group had a signi ficantly higher live birth rate (83%, 5/6 compared to the radical group (17%, 5/30). Additionally, the non -radical group had a signi ficantly higher implantation rate and cumulative live birth rate per oocyte retrieval (37%, 7/19 and 55%, 6/11 respectively) compared to the radical group (8%, 12/148 and 6%, 5/80 respectively).