Treatment for cervical intraepithelial neoplasia and subsequent IVF deliveries

Hum Reprod. 2008 Oct;23(10):2252-5. doi: 10.1093/humrep/den271. Epub 2008 Jul 16.

Abstract

Background: The aim was to study whether the treatment of cervical intraepithelial neoplasia (CIN) is associated with a subsequent increase in the use of IVF to achieve deliveries and whether women with cervical treatment and IVF have increased rates of preterm delivery.

Methods: This was a register-based retrospective cohort (n = 822 183 deliveries) study from Finland whose main outcome measures were the rates of IVF and preterm deliveries in different CIN treatment groups.

Results: Of all deliveries in Finland, 1.5% (12 240) resulted from IVF treatment. This proportion was 1.6% for women who had undergone any cervical procedure [n = 150, risk ratio (RR): 1.21, confidence interval (CI): 1.04-1.42]. The risk for IVF was not increased after cervical conization, whether by loop or laser (1.6%), or ablation (1.8%). An increased number of IVF deliveries (2.7%) was observed following other excisional treatments, even when adjusted for year of delivery (RR: 1.83, CI: 1.16-2.89) or parity (RR: 1.95, CI: 1.25-3.04). Although women who had undergone any cervical procedure and IVF appeared to have an increased relative risk for preterm delivery (3.42-fold, CI: 2.18-5.37) when compared with women with neither, this was explained by maternal age and parity.

Conclusions: The proportion of IVF deliveries was not increased after cervical conization or ablation. This is reassuring for young women who undergo such treatments.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Female
  • Fertilization in Vitro*
  • Gynecologic Surgical Procedures / adverse effects*
  • Humans
  • Infertility / epidemiology*
  • Middle Aged
  • Pregnancy
  • Pregnancy Outcome
  • Premature Birth / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Uterine Cervical Dysplasia / surgery*