Natural pregnancy or TAC?

Changes to fertility after cervical cancer
1

Hello,

I'm wondering if anyone else has been in this position and if so what decision they made and how it turned out. I have had a Lletz and Cone biopsy a couple of years ago. I was told i would need a stitch once pregnant. I got pregnant earlier this year but unfortunately ended in a missed miscarriage at 9 weeks. I was advised to see a consultant obstetrician so went to my preconception appointment last week. She found that i have less than 1.5cm cervix remaining and therefore thought i would be a good candidate for transabdominal cerclage. She then took me through to talk to the surgeon who carries these out to discuss the risks.

The surgeon is very reluctant for me to have the surgery seeing as we haven't "tested" what my body can cope with naturally and the surgery can have complications resulting in having to have a hysterectomy so she feels the risks are too high at this stage. She is recommending we try naturally to see if we can do it and i will be put on progesterone pessaries. What we didn't realise previously, is i do not have enough cervix remaining to have a stitch put in once i am pregnant. This means if my cervix starts to fail there is nothing they can do. Ultimately, our decision is between the following:

1. Try for a natural pregnancy with progesterone pessaries and scans every 2 weeks and hope my cervix holds, if it doesnt there is a relatively high chance we will lose the baby.

2. Have a TAC knowing that one of the risks of the procedures could mean i will not be able to have children.

We have had 2 professional opinions and waiting for a third. Both have said we should try the natural route first. 

I am wondering if anyone has been through something similar and if so can offer any advice on what they ended up doing and their experiences?

Thanks,

Jo

2

Oh Jo, what a decision to make. That’s a real tough one for you and your partner but sounds like you have totally the right approach to it by seeking other doctors opinions too.

i had a Successful tac pregnancy but didn’t have to make the choice. I believe the tac is a straightforward procedure for the right doctor.

there is a Facebook group called U.K. TAC support. The ladies on there are very knowledgable and might be able to suggest a doctor who performs a lot of tac authors who you could speak to,

good luck with everything x

3

Thank you for your reply and so glad the TAC has worked for you! We're going to see Dr Shennan in London next week and have made the decision to have it if he supports that decision. I don't really like the attitude of waiting until we've had a second trimester loss which feels inevitable nor putting baby through trauma of an early birth if there is another option. I think my current hospital the surgeon isn't very experienced so was possibly not comfortable doing the surgery unless she had to.

All the best xx

4

I'd also recommend the Incompetent Cervix UK FB group and perhaps pursue some of the recommended consultants.

I had a 1.9 left after the same procedures, had a standard stitch put in and made it to 35 wks before showing signs of early labour meant I had my elective section at 36wks. There is no doubt in my mind that the stitch made this possible. I don't think she'd be here without it.

Sorry you have to make such a touch decision.