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Baseline data included age, parity, disease stage, treatment characteristics, and FP methods applied. Data on reproductive outcomes and overall survival (by October 19, 2023) were retrieved from clinical registries and a population\u2010based register. Trial registration number: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link> NTC04602962.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 91 women were referred, 67% with stage I cancers and 25%, 7%, and 1% with stages II, III, and IV, respectively. Cancers were diagnosed during pregnancy or postpartum in six cases. Cancer treatments included fertility\u2010sparing surgery in 14%, hysterectomy in 30%, and radiochemotherapy in 79% of cases. The treatment modality did not rule out the possibility to undergo FP, and following counseling, 68 patients elected to undergo FP by cryopreservation of embryos or oocytes (<jats:italic>N<\/jats:italic>\u2009=\u200911), ovarian tissue (<jats:italic>N<\/jats:italic>\u2009=\u200954), or both (<jats:italic>N<\/jats:italic>\u2009=\u20093). After a mean follow\u2010up of 8.1\u2009years, 25 women (37%) returned to the center, five women achieved conception either spontaneously or through assisted reproduction, and 11 women became mothers through adoption or surrogacy. In the group of women receiving radical surgery or chemo\/radiotherapy, no live births using cryopreserved specimens have yet been achieved. During follow\u2010up, 7 women (10%) in the FP group and 5 women (24%) in the group without FP had died of their disease. Cancer recurrence was documented in 19 patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings underscore the complexity and challenges associated with FP in the context of cervix cancer. Results of this study demonstrate that many women diagnosed with cervix cancer at reproductive age desire to achieve parenthood. While fertility\u2010sparing surgery can allow pregnancy, those who undergo a hysterectomy are limited to adoption, surrogacy, or the emerging possibility of uterus transplantation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.15007","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T05:14:22Z","timestamp":1732166062000},"page":"86-94","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The complexity and challenges of fertility preservation in women with cervix cancer\u2014A prospective cohort study reporting on reproductive outcome and overall survival"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9131-7040","authenticated-orcid":false,"given":"Anna","family":"Marklund","sequence":"first","affiliation":[{"name":"Department of Reproductive Medicine, Division of Gynecology and Reproduction Karolinska University Hospital  Stockholm 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