Cervical surgery for cervical intraepithelial neoplasia and prolonged time to conception of a live birth: a case–control study
Article first published online: 14 MAR 2013
© 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 120, Issue 8, pages 960–965, July 2013
How to Cite
Cervical surgery for cervical intraepithelial neoplasia and prolonged time to conception of a live birth: a case–control study. BJOG 2013; DOI 10.1111/1471-0528.12209., , , .
- Issue published online: 11 JUN 2013
- Article first published online: 14 MAR 2013
- Manuscript Accepted: 4 FEB 2013
- National Institute of Child Health and Human Development (NICHD)
- National Institutes of Health NICHD. Grant Number: R01 HD39753
- National Institute of Allergy and Infectious Diseases (NIAID)
- National Institutes of Health. Grant Number: R21 AI1068111
- Cervical intraepithelial neoplasia, surgery;
- loop electrosurgical excisional procedure;
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.
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.
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).
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).
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).
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.