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. 2013 Jul;120(8):960-5.
doi: 10.1111/1471-0528.12209. Epub 2013 Mar 14.

Cervical surgery for cervical intraepithelial neoplasia and prolonged time to conception of a live birth: a case-control study

C N Spracklen  1 , K K Harland, B J Stegmann, A F Saftlas
Affiliations

Cervical surgery for cervical intraepithelial neoplasia and prolonged time to conception of a live birth: a case-control study

C N Spracklen et al. BJOG. 2013 Jul.

Abstract

Objective: To determine whether women with a history of surgery for cervical intraepithelial neoplasia (CIN) are at an increased risk of subfertility, measured as a time to pregnancy of more than 12 months.

Design: Case-control study.

Setting: Iowa Health in Pregnancy Study (IHIPS), a population-based case-control study of preterm and small-for-gestational-age (SGA) live birth outcomes (from May 2002 through June 2005) in the USA.

Sample: Women with an intended pregnancy and a history of either one prior cervical surgery (n = 152), colposcopy only (n = 151), or no prior cervical surgery or colposcopy (n = 1021).

Methods: Cervical treatment history, pregnancy intention, time to pregnancy, and other variables were self-reported by computer-assisted telephone interviews. Odds ratios were calculated using logistic regression to estimate the risk of prolonged time to pregnancy among women with a history of cervical surgery or colposcopy alone, compared with untreated women (control group).

Main outcome measure: Prolonged time to pregnancy (i.e. >1 year).

Results: Prolonged time to pregnancy was most prevalent among treated women (16.4%), compared with untreated women (8.4%) and women with colposcopy only (8.6%) (P = 0.039). After adjusting for covariates, women with prior cervical surgery had a more than two-fold higher risk of prolonged time to pregnancy compared with untreated women (aOR 2.09, 95% CI 1.26-3.46). In contrast, women with a history of colposcopy only had a risk equivalent to that found among untreated women (aOR 1.02, 95% CI 0.56-1.89).

Conclusions: Women with a history of cervical treatment for CIN are at increased risk of subfertility, measured as a time to pregnancy of more than 12 months.

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References

    1. Suarez S, Pacey A. Sperm transport in the female reproductive tract. Hum Reprod Update. 2006;12:23–37. - PubMed
    1. Larsson G, Grunsell H, Gullberg B, Svennerud S. Outcome of pregnancy after conization. Acta Obstet Gynecol Scand. 1982;61:461–66. - PubMed
    1. Luesley DM, McCrum A, Terry PB, Wade-Evans T, Nicholson HO, Mylotte MJ, et al. Complications of cone biopsy related to the dimensions of the cone and the influence of prior colposcopic assessment. Br J Obstet Gynceol. 1985;92:158–64. - PubMed
    1. Turlington WT, Wright BD, Powell JL. Impact of the loop electrosurgical excision procedure on future fertility. J Reprod Med. 1996;41:815–18. - PubMed
    1. Bigrigg A, Haffenden DK, Sheehan AL, Codling BW, Read MD. Efficacy and safety of large-loop excision of the transformation zone. Lancet. 1994;343:32–4. - PubMed

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