1 September 2025
September is Gynaecological Cancer Awareness Month, and it is designed to raise awareness about the symptoms, treatments and struggles associated with the diagnoses of five types of cancers. These are cervical, ovarian, uterine, vaginal and vulval cancer. Gynaecological cancer can be life altering, or life threatening in serious cases, and so drawing attention to the symptoms and available screening can increase the chances of an early detection. These diagnoses do not just affect women, but also anyone assigned female at birth who identifies differently, including trans men and non-binary people, as well as some intersex people who have female reproductive organs.
Gynaecological cancer can adversely affect family building and fertility. By its very nature of damaging reproductive organs, it can cause impaired fertility or absolute infertility, for example as a result of scarring. A loss of fertility can also come from treatment options used to treat these cancers, including chemotherapy, radiotherapy and surgery. By increasing awareness about the possibility of fertility loss, and by highlighting available methods to help manage this, it can also open the doors for potential future family building. An integral part of this is raising understanding of not just the medical aspects but the legal issues as well to ensure that individual fertility and family building wishes are maximised and legally protected. Given the complexity of fertility and family building law, this makes it important to identify and implement effective legal strategies with a specialist fertility and family lawyer to plan fertility and preconception, pregnancy, birth and family life including the use of gamete and embryo freezing, IVF, surrogacy, donor conception and posthumous conception.
Cervical Cancer
Cervical cancer is typically caused by human papilloma virus, known as HPV, and it is most common in women over 30 to be diagnosed with this type of cancer (although it can occur in younger women as well). There are several factors which can increase the chances of being diagnosed, including having unprotected sex and smoking tobacco. There are several screening tests to aid in an early diagnosis of cervical cancer which typically begin after the age of 21- the HPV test and a cervical smear test. As there are rarely symptoms of cervical cancer in its early stages (by the time symptoms appear cancer is more advanced), these tests can help with early detection.
A cervical smear test does not just highlight cancerous cells, but also precancerous cells. As such, a positive test result can identify abnormal changes in cervical cells that could indicate a future development of cancer (not just the existence of cancer) and is one of the most effective ways of preventing cervical cancer and aiding early diagnosis and treatment. Additionally, there is an HPV vaccine that is recommended for children between the ages of 12-13 on the NHS. This drastically reduces the chances of developing cervical cancer through HPV.
Ovarian Cancer
Each year in the UK, 7,500 women are diagnosed with ovarian cancer, which makes it the 6th most common cancer in women. There are three types of ovarian cancer. One is germ cell cancer, which begins in the cells which develop into eggs, the second is sex cord stromal cancers which is in the supporting tissue for the ovary, and the third is cancer in the covering layer of the ovary, fallopian tube or peritoneum.
Unlike cervical cancer, there are still no regular screening tests available for ovarian cancer. The initial stage of testing is done at the GP by conducting a vaginal examination, as well as externally by palpating the stomach. Further tests then include blood tests, transvaginal ultrasounds, CT scans, needle biopsies and tissue biopsies. However, examinations by GP’s are only prompted after symptoms have arisen (including bloating, stomach pain, digestive issues and fatigue) at which point the cancer may have already progressed. This unfortunately makes ovarian cancer harder to diagnose and treat, meaning survival rates vary depending upon the stage at which a diagnosis and treatment start.
Uterine Cancer
There are two types of uterine cancer: endometrial cancer that begins in the lining of the uterus known as the endometrium, and uterine sarcomas, which develop in the muscular wall of the uterus. The latter of these two is much rarer, with only 5% of uterine cancer cases being sarcomas.
Some causes of uterine cancer are a high-level oestrogen or other hormone related issues, a late menopause, polycystic ovary syndrome and having never given birth. So, for any person who may be at an increased risk for this, it is important to monitor for any potential symptoms. Common symptoms include abdominal swelling, abnormal vaginal bleeding, changes to discharge, different bowel and bladder movements. To confirm a diagnosis, the relevant tests would then be carried out. Namely, a patient would be referred for a transvaginal scan, blood tests, hysteroscopy (inserting a camera into the womb), biopsies, CT scans or MRI scans. In terms of survival rates, seven out of ten women in the UK will survive uterine cancer for ten years or more.
Vaginal and Vulval Cancer
Vaginal cancer is a very rare type of cancer, with approximately 250 cases diagnosed annually in the UK, and it is most common in people 75 and over. It originates primarily from HPV, much like cervical cancer, and can often be prevented by cervical screening. In vaginal cancer cases, cells from cervical cancer migrate to an area within the vagina and can develop into lumps, ulcers, skin changes as well as unusual bleeding and discharge.
Vulval Cancer is also commonly caused by HPV but can also develop from skin conditions that affect the vulva namely, a mole that changes shape and colour can indicate the presence of cancer.
Impact on Fertility and Family Building
Along with the incredibly complex physical and emotional impact of a gynaecological cancer diagnosis, it can adversely impact a patient’s fertility and future family building wishes. This can arise from both the direct consequences of these cancers, as well as the available treatment options. For someone who is already struggling with a daunting cancer diagnosis, it can take an emotional toll to find out about the possible negative impact on their chances of conceiving a child. So, it is important to discuss why this is the case and consider the possible ways to manage this.
Two of the most widely used treatments for cancer diagnoses are chemotherapy and radiotherapy. Chemotherapy is a powerful drug that is used to target and kill fast growing cells to stunt the growth or metastaticity of the cancer. Radiotherapy uses high energy beams, like x-rays, to target cells at a specific site. However, it is common that following these types of treatments patients are left infertile, or unable to carry a child. Namely, with uterine or ovarian cancers, if radiotherapy is targeting these sites, this can cause premature menopause and consequent infertility. Similarly, with more aggressive types of chemotherapy, this can indirectly target a patient’s egg cells, causing them to no longer be viable, even if the cancer is present elsewhere.
Surgeries are also common routes to tackle gynaecological cancers by removing either the affected areas, or organs and wider tissues. These types of operations include partial or total hysterectomies (removal of the womb, and sometimes the cervix), oophorectomies (removal of the ovaries), and tumour resections. In cases where a large part (or all) of the ovaries or womb are removed, this can prevent someone from conceiving. This can either be because they have very few, or no eggs remaining, have no viable womb to carry a child or no cervix to support a pregnancy and childbirth.
The last instance where fertility can be impacted is through scarring. Scarring on the ovaries, uterine tissue and the uterus can hinder a person’s chance at conceiving or carrying a pregnancy to full term. And, unfortunately, in some cases with significant scarring, it may render a person infertile.
Ways Forward
Despite the negative effects that a gynaecological cancer diagnosis can have on a person’s fertility, this does not mean that family building is completely unattainable. In fact, with advances in IVF, fertility treatment and effective navigation of fertility law and modern family law, there are a range of ways a person can start a family.
One option is to explore egg freezing. For cancer patients, this service is available on the NHS and can allow a patient’s eggs to be stored for up to 55 years under UK fertility law. This enables IVF to be undertaken later down the line utilising their own eggs and gives them options to start a family and conceive their own genetic child. In doing so, it is important to obtain specialist legal advice as to the legal rights, storage and use of any frozen eggs to ensure the best possible chances of successfully using these in future family building during a patient’s own lifetime or after death (in posthumous conception).
To find out more about fertility preservation law in the UK click here.
IVF is another method which is commonly used to support cancer patients and survivors start a family. This can be coupled with donor conception, where patients can use donated eggs, if for example, their eggs are no longer viable. It is important to keep in mind, though, that IVF is not always available on the NHS in every region due to the ongoing NHS postcode funding lottery. Alternatively, IVF and donor conception can be accessed on a privately funded basis at UK fertility clinics. In undertaking IVF, it is advisable to obtain specialist legal advice to identify relevant legal issues and implications, including what rights you (and any partner) will have over your child, and understand how best to go about your treatment to ensure the best outcome.
To find out more about fertility treatment law in the UK click here.
To find out more about donor conception law in the UK click here.
Surrogacy provides another family building option for gynaecological cancer patients and survivors who cannot carry a pregnancy. This allows for a person, who may still have viable eggs, but cannot themselves carry the child to have a much wanted child. In doing so, a patient’s genetic legacy can still be preserved despite their fertility struggles.
To find out more about surrogacy law click here.
It is also important to carefully consider and manage the legal requirements of posthumous conception to enable a partner, spouse, or nominated person, to use a deceased individual’s gametes (or embryos comprising these) to have a child after their death. Posthumous conception law in the UK is complex, making it very important to obtain specialist legal advice to comply with specific legal requirements that document a gamete provider’s informed, written and signed consent to the storage and use of their gametes after their death to ensue their family building wishes are respected and their genetic legacy is preserved. This will ensure that the correct legal forms and procedures are carried out to maximise the chances of posthumous conception following death.
To find out more about posthumous conception law in the UK click here.
If you, or a loved one, is at risk or is facing a gynaecological cancer diagnosis, it is advisable to seek expert fertility and family building law advice. This can help proactively maximise and protect individual fertility during life or after death. It can also help put into place effective legal and practical strategies to navigate fertility treatment, pregnancy, birth, and family life. If you would like to discuss your situation, or if you require specialist fertility, surrogacy and/or family law advice and assistance, please contact Louisa Ghevaert by email at louisa@louisaghevaertassociates.co.uk or by telephone +44 (0)20 79658399.
Images: Louisa Ghevaert CEO & Founder of Louisa Ghevaert Associates
To find out more about Louisa Ghevaert click here.
