This protocol addresses patients of reproductive age diagnosed with cervical adenocarcinoma in situ who wish to preserve fertility. The relevant conditions for this pathway are: negative margin status has been achieved on cervical conization, and the patient is willing and able to adhere to ongoing surveillance recommendations.
The combination of reproductive-age presentation, fertility intent, confirmed negative conization margins, and commitment to surveillance defines a specific subgroup for whom conservative — rather than definitive surgical — management may be appropriate. Each of these criteria shapes the clinical decision pathway.
For patients of reproductive age who desire future pregnancy, for whom negative margin status on conization has been achieved, and who are willing and able to adhere to surveillance recommendations, fertility-sparing management with a conization procedure is acceptable (AII).
DOI: 10.1097/AOG.0000000000003761