{"id":6373,"date":"2025-05-09T16:22:34","date_gmt":"2025-05-09T14:22:34","guid":{"rendered":"https:\/\/pre.juanacrespo.com\/caso\/embarazo-evolutivo-con-rnv-y-sano-tras-cancer-de-cuello-uterino-protesis-cervical\/"},"modified":"2026-03-16T20:33:51","modified_gmt":"2026-03-16T19:33:51","slug":"ongoing-pregnancy-with-a-healthy-live-birth-after-cervical-cancer-cervical-prosthesis","status":"publish","type":"caso","link":"https:\/\/juanacrespo.com\/en\/case\/ongoing-pregnancy-with-a-healthy-live-birth-after-cervical-cancer-cervical-prosthesis\/","title":{"rendered":"Ongoing pregnancy with a healthy live birth after cervical cancer: Cervical prosthesis"},"content":{"rendered":"<p><b>Summary:<\/b><\/p>\n<p><span style=\"font-weight: 400;\">A 29-year-old woman attended the clinic after undergoing a radical trachelectomy for stage IB1 cervical adenocarcinoma, with preservation of part of the uterus.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Her medical history included <\/span><b>two <\/b><span style=\"font-weight: 400;\">previous<\/span><b> spontaneous pregnancies<\/b><span style=\"font-weight: 400;\"> that ended in miscarriage, likely due to bacterial infections in the vaginal cerclage performed after the trachelectomy.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">She came to the high-complexity fertility clinic Equipo Juana Crespo to undergo a deferred IVF treatment and achieve pregnancy. This required reproductive surgery by hysteroscopy with placement of a cervical prosthesis, followed by its removal.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">After the surgeries and personalized treatment, the patient achieved a first pregnancy resulting in a healthy live birth.<\/span><\/p>\n<p><b>Medical history\u00a0<\/b><\/p>\n<p><span style=\"font-weight: 400;\">29-year-old woman seeking pregnancy, diagnosed with <\/span><b>cervical adenocarcinoma.<\/b><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Previous <\/span><b>fertility-preserving oncological surgery<\/b><span style=\"font-weight: 400;\">, including:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Trachelectomy<\/b><span style=\"font-weight: 400;\"> (resection of the uterine cervix)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sentinel lymph node study<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Pelvic lymphadenectomy<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Two <\/span><b>late miscarriages<\/b><span style=\"font-weight: 400;\"> (beyond 18 weeks of gestation)<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Two <\/span><b>previous vaginal cerclages<\/b><\/p>\n<p><span style=\"font-weight: 400;\">One <\/span><b>abdominal cerclage<\/b><span style=\"font-weight: 400;\"> by laparoscopy<\/span><\/p>\n<h3><\/h3>\n<p><b>Previous treatments:<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Four artificial inseminations with no positive result<\/span><\/p>\n<h3><\/h3>\n<p><b>Diagnosis:<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Cervical incompatibility with possible pregnancy through the external cervical os located in the first third of the cervical canal after abdominal cerclage, preventing embryo implantation and pregnancy.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Polycystic ovaries (PCO)<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Implants due to retrograde menstruation\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Adhesions in the pelvic surgical area (left iliac fossa)<\/span><\/p>\n<p><span style=\"font-weight: 400;\">High risk of hemoperitoneum during embryo transfer<\/span><\/p>\n<h3><\/h3>\n<p><b>Therapeutic plan<\/b><\/p>\n<p><span style=\"font-weight: 400;\">A comprehensive approach was designed, including:<\/span><\/p>\n<ul>\n<li aria-level=\"1\"><b>Controlled ovarian stimulation: obtaining embryos.<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Stimulation was carefully planned due to her <\/span><b>high follicular count<\/b><span style=\"font-weight: 400;\">, resulting in <\/span><b>18 good-quality embryos.<\/b><\/p>\n<ul>\n<li aria-level=\"1\"><b>Advanced uterine and cervical assessment<\/b><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The evaluation was completed with <\/span><b>magnetic resonance imaging (MRI)<\/b><span style=\"font-weight: 400;\">, followed by <\/span><b>diagnostic and therapeutic hysteroscopy<\/b><span style=\"font-weight: 400;\"> under sedation, during which <\/span><b>reparative uterine microsurgery<\/b><span style=\"font-weight: 400;\"> was performed along with a novel surgical approach involving the placement and subsequent removal of a cervical prosthesis.<\/span><\/p>\n<h3><\/h3>\n<p><b>\u00a0Surgical innovation: customized cervical prosthesis<\/b><\/p>\n<p><span style=\"font-weight: 400;\">The embryo transfer was expected to be highly complex due to the sequelae of the oncological treatment. For this reason, a <\/span><b>customized cervical prosthesis<\/b><span style=\"font-weight: 400;\"> was designed to facilitate access and optimize the transfer. The cervical prosthesis consists of a biocompatible conical device, carefully placed to allow access for the transfer. Its placement requires detailed anatomical knowledge of the cervix, individualized to each case, and a precise surgical technique to ensure correct positioning.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">This innovative technique was developed and applied by Dr. G\u00f3mez and Dr. Crespo, marking a milestone in post-oncological fertility approaches.<\/span><\/p>\n<h3><\/h3>\n<p><b>Endometrial preparation and embryo transfer<\/b><\/p>\n<p><span style=\"font-weight: 400;\">During the endometrial preparation phase, led by Dr.<\/span> <span style=\"font-weight: 400;\">Fortu\u00f1o, mock transfers were performed to accurately map the pathway to be followed on the key day.<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>The second embryo transfer<\/b><span style=\"font-weight: 400;\"> was successful.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The pregnancy progressed without complications.<\/span><\/li>\n<\/ul>\n<h3><\/h3>\n<p><span style=\"font-weight: 400;\">The treatment culminated in the birth of a <\/span><b>healthy, full-term newborn at more than 39 weeks of gestation.<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Three years later, thanks to the previously planned strategy, the patient achieved a <\/span><b>second successful pregnancy<\/b><span style=\"font-weight: 400;\">, confirming the effectiveness of the multidisciplinary and personalized approach.<\/span><\/p>\n<h3><\/h3>\n<p><b>Conclusion<\/b><\/p>\n<p><span style=\"font-weight: 400;\">This case shows that, even after a complex oncological and surgical diagnosis, it is possible to achieve motherhood with the help of innovative techniques, surgical planning, and a highly specialized medical approach.<\/span><\/p>\n","protected":false},"featured_media":257,"template":"","meta":{"_acf_changed":false,"inline_featured_image":false},"categoria-de-caso":[],"class_list":["post-6373","caso","type-caso","status-publish","has-post-thumbnail","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/juanacrespo.com\/en\/wp-json\/wp\/v2\/caso\/6373","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/juanacrespo.com\/en\/wp-json\/wp\/v2\/caso"}],"about":[{"href":"https:\/\/juanacrespo.com\/en\/wp-json\/wp\/v2\/types\/caso"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/juanacrespo.com\/en\/wp-json\/wp\/v2\/media\/257"}],"wp:attachment":[{"href":"https:\/\/juanacrespo.com\/en\/wp-json\/wp\/v2\/media?parent=6373"}],"wp:term":[{"taxonomy":"categoria-de-caso","embeddable":true,"href":"https:\/\/juanacrespo.com\/en\/wp-json\/wp\/v2\/categoria-de-caso?post=6373"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}